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Optics Express Mar 2024Diffractive optics is a valuable technique for designing presbyopia-correcting lenses, but its effectiveness is wavelength-dependent. This study investigates the...
Diffractive optics is a valuable technique for designing presbyopia-correcting lenses, but its effectiveness is wavelength-dependent. This study investigates the spatio-chromatic alterations in visual resolution associated with diffractive multifocal lenses by using non-invasive, removable diffractive bifocal contact lenses. The study combines theoretical analysis, numerical simulation, and clinical intra-observer experiments to assess visual acuity under various lighting conditions. Results demonstrate the introduction of spatio-chromatic asymmetry and a change in visual acuity under red and blue lights, depending on the operating diffraction order employed in the lens design. The energy distribution of the diffractive contact lens studied favors resolution under red illumination at far distances and under blue illumination at near distances. These findings are consistent with computational simulations and provide insights into the visual changes induced by diffractive ophthalmic lenses.
PubMed: 38571249
DOI: 10.1364/OE.512212 -
PloS One 2024Presbyopia, the leading cause of vision impairment globally, is common during working years. However, no trials have assessed presbyopia's impact on income. (Randomized Controlled Trial)
Randomized Controlled Trial
The effect on income of providing near vision correction to workers in Bangladesh: The THRIVE (Tradespeople and Hand-workers Rural Initiative for a Vision-enhanced Economy) randomized controlled trial.
INTRODUCTION
Presbyopia, the leading cause of vision impairment globally, is common during working years. However, no trials have assessed presbyopia's impact on income.
METHODS
In April 2017, we conducted a census among 59 Bangladesh villages to identify persons aged 35 to 65 years with presbyopia (presenting distance vision > = 6/12 bilaterally and correctable inability to see 6/13 at 40 cm with both eyes), who never had owned glasses. Participants were randomized (1:1) to receive immediate free reading glasses (intervention) or glasses delivered 8 months later (control). Visual demand of different jobs was stratified into three levels. Outcomes were between-group differences in the 8 month change in: self-reported monthly income (primary) and Near Vision Related Quality of Life (NVRQOL, secondary).
RESULTS
Among 10,884 census participants, 3,655 (33.6%) met vision criteria and 863 (23.6%) comprised a sample enriched for near vision-intensive jobs, but 39 (4.52%) could not be reached. All participants allocated to intervention (n = 423, 51.3%) and control (n = 401, 48.7%) received the appropriate intervention, and follow-up was available for 93.4% and 96.8% respectively. Groups were similar at baseline in all characteristics: mean age was 47 years, 50% were male, 35% literate, and about half engaged in "most near vision-intensive" occupations. Glasses wear at 8-month follow-up was 88.3% and 7.81% in intervention and control respectively. At baseline, both the intervention and control groups had a self-reported median monthly income of US$35.3. At endline, the median income for the intervention group was US$47.1 compared with US$35.3 for control, a difference of 33.4%. Predictors of greater income increase in multivariate models included intervention group allocation (OR 1.45, 95% CI 1.12, 1.88, P = 0.005), male sex (OR 2.41, 95% CI 1.84, 3.16, P <0.001), and not engaging in income-producing work at baseline (OR 2.35, 95% CI 1.69, 3.26, P<0.001).
CONCLUSION
Provision of reading glasses increases income in near vision-intensive occupations, and may facilitate return to work for those currently unemployed.
Topics: Female; Humans; Male; Middle Aged; Bangladesh; Myopia; Presbyopia; Quality of Life; Vision, Ocular; Adult; Aged
PubMed: 38568883
DOI: 10.1371/journal.pone.0296115 -
BMC Ophthalmology Mar 2024To investigate the correlation of angles α and κ with the refractive and biological parameters in children.
AIM
To investigate the correlation of angles α and κ with the refractive and biological parameters in children.
METHODS
This case-series study included 438 eyes of 219 children (males/females = 105/114, age: 3-15 years). Ocular biometric parameters, including axial length, corneal radius of curvature (CR), white-to-white distance (WTW), angle κ and angle α, were measured using IOL Master 700; auto-refraction were assessed under cycloplegia. The eyes were assigned to different groups based on CR, WTW, and gender to compare the angles α and κ, and analyze the correlations between the differences of biological parameters on angles α and κ.
RESULTS
The means of axial length, CR, WTW, angle α, and angle κ were 23.24 ± 1.14 mm, 7.79 ± 0.27 mm, 11.68 ± 0.41 mm, 0.45 ± 0.25 mm, and 0.27 ± 0.22 mm, respectively. Angle α was correlated with CR and WTW (fixed effect coefficient [FEC] = 0.237, p = 0.015; FEC = -0.109, p = 0.003; respectively), and angle κ also correlated with CR and WTW (FEC = 0.271, p = 0.003; FEC = -0.147, p < 0.001, respectively). Comparing subgroups, the large CR and small WTW group had larger angles α (0.49 ± 0.27 vs. 0.41 ± 0.21, p < 0.001; 0.46 ± 0.27 vs. 0.44 ± 0.21, p < 0.05, respectively) and κ (0.29 ± 0.25 vs. 0.24 ± 0.15, p < 0.01; 0.29 ± 0.25 vs. 0.26 ± 0.19, p < 0.05, respectively). The differences in interocular angles α and κ showed correlation with interocular WTW (r = - 0.255, p < 0.001; r = - 0.385, p < 0.001). Eyes with smaller WTW tended to have larger angle κ (0.28 ± 0.27 vs. 0.25 ± 0.15, p < 0.05).
CONCLUSION
The size of angle α/κ may be correlated to CR and WTW, and a larger WTW eye may suggest a smaller angle κ compared with the fellow eye.
Topics: Child; Humans; Female; Male; Child, Preschool; Adolescent; Refraction, Ocular; Vision Tests; Cornea; Presbyopia; Biometry; Axial Length, Eye
PubMed: 38549060
DOI: 10.1186/s12886-024-03409-6 -
Journal of Cataract and Refractive... Jul 2024To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended...
PURPOSE
To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended depth-of-focus (EDOF) pattern and a diffractive multifocal platform.
SETTING
Miranza COI Bilbao, Bilbao, Spain.
DESIGN
Prospective case series.
METHODS
35 patients (51 to 84 years) with corneal astigmatism ranging from 0.75 to 2.19 diopters (D) undergoing bilateral cataract surgery with implantation of the Synergy Toric II IOL were evaluated during a 3-month follow-up. Visual acuity, refraction, defocus curve, and patient-reported outcomes with the Catquest-9SF questionnaire were analyzed. A vectorial analysis was used to analyze the accuracy of astigmatic correction.
RESULTS
Mean 3-month monocular postoperative uncorrected distance, intermediate (80 cm) and near (40 cm) visual acuities were 0.06 ± 0.11 logMAR, 0.13 ± 0.12 logMAR, and 0.13 ± 0.09 logMAR, respectively. Mean monocular distance-corrected intermediate (80 cm) and near visual acuity (40 cm) were 0.11 ± 0.12 logMAR and 0.10 ± 0.10 logMAR, respectively. Mean binocular defocus curve showed visual acuities of 0.10 logMAR or better for defocus levels from +0.50 to -2.50 D. Residual cylinder was within ±0.50 D in 97.0% of eyes. The surgically induced astigmatism prediction error ranged between -0.49 D and 0.50 D, with a mean value of 0.04 ± 0.16 D. Mean absolute IOL rotation was 3.79 ± 2.94 degrees. Significant improvements were found in all Rasch-calibrated scores obtained with Catquest-9SF ( P < .001).
CONCLUSIONS
The implantation of the toric presbyopia-correcting IOL evaluated provides an efficacious astigmatic correction while providing a fully restoration of the visual function across different distances.
Topics: Humans; Visual Acuity; Presbyopia; Prospective Studies; Aged; Refraction, Ocular; Lens Implantation, Intraocular; Middle Aged; Aged, 80 and over; Lenses, Intraocular; Male; Female; Astigmatism; Phacoemulsification; Prosthesis Design; Pseudophakia; Surveys and Questionnaires; Treatment Outcome
PubMed: 38530027
DOI: 10.1097/j.jcrs.0000000000001428 -
Graefe's Archive For Clinical and... Mar 2024This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF)...
PURPOSE
This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs.
METHODS
This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration.
RESULTS
The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm.
CONCLUSIONS
MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs.
PubMed: 38526773
DOI: 10.1007/s00417-024-06458-1 -
Graefe's Archive For Clinical and... Mar 2024To explore the impact of refractive status on presbyopia progression among patients with presbyopia.
PURPOSE
To explore the impact of refractive status on presbyopia progression among patients with presbyopia.
METHODS
This retrospective observational study included patients with presbyopia who visited the Seventh Affiliated Hospital of Sun Yat-sen University and Shenzhen Polytechnic Medical College between May 2018 and August 2022. The amplitude of accommodation (AMP) and near addition power (ADD) at 6 months and 1 year were collected.
RESULTS
A total of 103 patients with presbyopia were included in this study: 42 patients with myopia, 23 patients with emmetropia, and 38 patients with hyperopia. There were significant differences in ΔAMP and ΔADD among patients with different refractive statuses, and the values of emmetropic patients and hyperopic patients were higher than in myopic patients (all P < 0.001). The ΔAMP and ΔADD of hyperopic patients were significantly higher than in emmetropic patients and myopic patients (all P < 0.001). The ΔADD of emmetropic patients was greater than in myopic patients (P = 0.045), but there were no significant differences in ΔAMP between patients with emmetropia and myopia (P = 0.090).
CONCLUSIONS
The progression of presbyopia in hyperopic patients was relatively more significant than for emmetropia, followed by myopia. The prescription of presbyopia glasses might need to be replaced more frequently in patients with hyperopia.
PubMed: 38512509
DOI: 10.1007/s00417-024-06455-4 -
International Ophthalmology Mar 2024To identify the rate and characteristics of cataract surgery candidates suitable for multifocal intraocular lens implantation among patients undergoing preoperative...
PURPOSE
To identify the rate and characteristics of cataract surgery candidates suitable for multifocal intraocular lens implantation among patients undergoing preoperative evaluation in a public hospital.
MATERIALS AND METHODS
Screening was performed based on the patient's medical records, comprehensive ophthalmic examination, optical biometry (Zeiss, IOL Master 700) and optical coherence tomography (OCT) (Heidelberg, OCT Spectralis) in accordance with the relevant indications and contraindications mentioned in the pertinent literature. Patients were included in the present study if they were eligible for bilateral cataract surgery. The exclusion criteria were the presence of central nervous system or motility issues, prior refractive surgery, the presence of astigmatism greater than 1 dioptre and/or the presence of important ocular comorbidities in either eye.
RESULTS
The study evaluated 1200 consecutive patients. Four hundred thirty-two patients (36%) were not eligible for bilateral surgery and were excluded from the study. Of the 768 patients included in the present study, 346 (45.1%) were considered suitable candidates. Four hundred twenty-two patients (54.9%) were excluded for one or both eyes. Among them, 121 (28.7%) were excluded because of retinal disease, 120 (28.4%) because of regular astigmatism (> 1.0 D of corneal astigmatism), 32 (7.5%) because of pseudoexfoliation or zonular instability, and 30 (7.1%) because of glaucoma or ocular hypertension; in addition, 90 (21.3%) patients were excluded for multiple reasons. Suitable candidates were significantly younger (70 and 75 years, respectively) (p < 0.001). After being informed about the potential risks and benefits of MOIL implantation, 212 of 346 (83.8%) eligible patients provided consent.
CONCLUSION
Close to half of cataract patients in a public hospital were eligible for MOIL implantation, and the majority of patients would proceed to surgery. The most prevalent contraindication was macular disease.
Topics: Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Visual Acuity; Astigmatism; Phacoemulsification; Cataract; Refraction, Ocular
PubMed: 38507136
DOI: 10.1007/s10792-024-03088-8 -
Journal of Vision Mar 2024Accommodation is the process of adjusting the eye's optical power so as to focus at different distances. Uncorrected refractive error and/or functional presbyopia mean...
Accommodation is the process of adjusting the eye's optical power so as to focus at different distances. Uncorrected refractive error and/or functional presbyopia mean that sharp focus may not be achievable for some distances, so observers experience sustained defocus. Here, we identify a problem with current models of accommodative control: They predict excessive internal responses to stimuli outside accommodative range, leading to unrealistic adaptation effects. Specifically, after prolonged exposure to stimuli outside range, current models predict long latencies in the accommodative response to stimuli within range, as well as unrealistic dynamics and amplitudes of accommodative vergence innervation driven by the accommodative neural controller. These behaviors are not observed empirically. To solve this issue, we propose that the input to blur-driven accommodation is not retinal defocus, but correctable defocus. Predictive models of accommodative control already estimate demand from sensed defocus, using a realistic "virtual plant" to estimate accommodation. Correctable defocus can be obtained by restricting this demand to values physically attainable by the eye. If we further postulate that correctable defocus is computed using an idealized virtual plant that retains a young accommodative range, we can explain why accommodative-convergence responses are observed for stimuli that are too near-but not too far-to focus on. We model cycloplegia as a change in gain, and postulate a form of neural myopia to explain the additional relaxation of accommodation often seen with cycloplegia. This model produces plausible predictions for the accommodative response and accommodative convergence signal in a wide range of clinically relevant situations.
Topics: Humans; Presbyopia; Refractive Errors; Accommodation, Ocular; Myopia; Retina
PubMed: 38488409
DOI: 10.1167/jov.24.3.4 -
Contact Lens & Anterior Eye : the... Jun 2024A common non-spectacle strategy to correct presbyopia is to provide simultaneous images with multifocal optical designs. Understanding the neuroadaptation mechanisms...
A common non-spectacle strategy to correct presbyopia is to provide simultaneous images with multifocal optical designs. Understanding the neuroadaptation mechanisms behind multifocal devices usage would have important clinical implications, such as predicting whether patients will be able to tolerate multifocal optics. The aim of this study was to evaluate the brain correlates during the initial wear of multifocal contact lenses (CLs) using high-density visual evoked potential (VEP) measures. Fifteen presbyopes (mean age 51.8 ± 2.6 years) who had previously not used multifocal CLs were enrolled. VEP measures were achieved while participants looked at arrays of 0.5 logMAR Sloan letters in three different optical conditions arranged with CLs: monofocal condition with the optical power appropriate for the distance viewing; multifocal correction with medium addition; and multifocal correction with low addition. An ANOVA for repeated measures showed that the amplitude of the C1 and N1 components significantly dropped with both multifocal low and medium addition CL conditions compared to monofocal CLs. The P1 and P2 components showed opposite behavior with an increase in amplitudes for multifocal compared to monofocal conditions. VEP data indicated that multifocal presbyopia corrections produce a loss of feedforward activity in the primary visual cortex that is compensated by extra feedback activity in extrastriate areas only, in both early and late visual processing.
Topics: Humans; Presbyopia; Male; Visual Cortex; Middle Aged; Female; Evoked Potentials, Visual; Contact Lenses; Visual Acuity
PubMed: 38485618
DOI: 10.1016/j.clae.2024.102137 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and...
Bilateral Femtosecond Laser-Assisted Clear Lens Extraction with Trifocal Intraocular Lens Implantation for Presbyopia Correction: A Short-Term Observational Study in Chinese Adults.
PURPOSE
To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and evaluate its feasibility in early presbyopic adults.
METHODS
Prospective case series of eyes with clear crystalline lenses that underwent femtosecond laser-assisted lens extraction and trifocal IOL (Acrysof IQ PanOptix, Model TFNT00, Alcon) implantation between 2021 and 2023 were followed up for at least 3 months after surgery. Outcome measures included monocular uncorrected visual acuity at near (UNVA, 40 cm), intermediate (UIVA, 60 cm), and distance (UDVA, 5 m), monocular manifest refraction, corrected distance visual acuity (CDVA), defocus curve assessment, and spectacle independence at both near and distance.
RESULTS
A total of 60 eyes from 30 consecutive patients were included, and their mean age was 50.4±6.5 years. After surgery, the mean UNVA (LogMAR) increased from 0.28±0.16 to 0.08±0.07, UIVA increased from 0.25±0.12 to 0.09±0.06, and UDVA increased from 0.27±0.21 to 0.01±0.08. The enhancements of UNVA, UIVA and UDVA were all significant (P < 0.05). The optometric results showed that the mean postoperative spherical equivalent (SE) was -0.21±0.24 D, and the mean postoperative CDVA (LogMAR) was -0.00±0.06. The preoperative spectacle independences at near and distance were 46.7% (14/30) and 56.7% (17/30), respectively, and both increased to 100% at 3 months after surgery.
CONCLUSION
Satisfactory visual outcomes and safe surgical procedures were observed in this study, which demonstrate that bilateral femtosecond laser-assisted clear lens extraction with PanOptix IOL implantation could be a feasible approach for presbyopia correction in working-age Chinese patients.
PubMed: 38481540
DOI: 10.2147/OPTH.S453143