BACKGROUND Myopia and high myopia are global public health concerns.Patients with high myopia account for 0.5%-5.0%of the global population.AIM To examine diopters,axial length(AL),higher-order aberrations,and other o...BACKGROUND Myopia and high myopia are global public health concerns.Patients with high myopia account for 0.5%-5.0%of the global population.AIM To examine diopters,axial length(AL),higher-order aberrations,and other ocular parameters in Chinese children with myopia,to analyze the influence of structural parameters associated with myopia on visual quality,and to provide a theoretical basis for the prevention and treatment of childhood myopia and high myopia.METHODS This study included 195 children aged 6–17 years with myopia.The AL was measured with an ultrasonic ophthalmic diagnostic instrument,and the aberrations,corneal curvature(minimum K1,maximum K2,and average Km),central corneal thickness,anterior chamber depth,and anterior chamber angle were measured using a Sirius three-dimensional anterior segment analyzer.Using a standard formula,the corneal radius of curvature R(337.3/Km)and AL/R values were obtained.RESULTS The diopter of high myopia compared with low-middle myopia was correlated with age and AL(r=-0.336,-0.405,P<0.001),and AL of high myopia was negatively correlated with K1,K2,and Km(r=-0.673,-0.661,and-0.680,respectively;P<0.001),and positively correlated with age and the anterior chamber depth(r=0.214 and 0.275,respectively;P<0.05).AL/R was more closely related to diopter than AL in children with myopia,and 94.4%of children with myopia had an AL/R of>3.00.CONCLUSION The ocular structural parameters of children change because of different diopters.AL/R is more specific and sensitive than AL in evaluating the refractive status of myopia in children.An AL/R of>3.00 may be used as a specific index of myopia in children.There are differences in AL/R between high myopia and low-middle myopia,which can be used for the classification of ametropia.The degree of myopia has a certain influence on higher-order aberrations.展开更多
Background: Individualized corneal refractive surgery requires an understanding of the basis of higher-order aberrations before surgery. To investigate the characteristics and distribution of anterior surface wavefron...Background: Individualized corneal refractive surgery requires an understanding of the basis of higher-order aberrations before surgery. To investigate the characteristics and distribution of anterior surface wavefront aberrations in patients suitable for corneal refractive surgery. Methods: A total of 121 myopic patients (121 eyes, 18 - 45 years old) who underwent corneal refractive surgery were recruited from January to May 2016 at Affiliated Hospital, Yanbian University. Patients were randomly selected by the Pentacam anterior segment analysis system with a spherical equivalent (SE) of -0.25 to -10.00 D. The corneal anterior aberrations (total higher-order aberration;spherical aberration;Coma;Trefoil) and Q and K values were detected, and a correlation analysis of the relevant parameters was carried out. Results: The root-mean-square (RMS) of the third to sixth order aberrations of the corneal anterior wavefront aberrations at a 6 mm analysis diameter showed a decreasing trend in patients suitable for the corneal refractive surgery, and the RMS of the third order aberrations accounted for 62.92% of the total HOAs. The coma ratio (coma/total cornea higher-order aberrations) was increased with the increasing diopters, while the spherical aberration ratio (spherical aberration/total cornea higher-order aberrations) was not changed. In addition, the spherical aberration was 0.203 ± 0.082 μm (range: 0.061 to 0.503 μm), and the Q30 was -0.19 ± 0.03 (range: -0.58 to 0.31). There were significant differences in the coma aberrations of preoperative corneal anterior surface (3, 1) between the low, middle and high myopia groups (P = 0.013). The spherical equivalent was positively correlated with the corneal coma of the anterior corneal surfaces (R =?-0.241, P = 0.009), and the Q value was positively correlated with the total higher-order aberrations (R = 0.326, P Conclusions: Individual wavefront aberrations on the anterior surfaces of the cornea are comparatively different, and the Zernike coefficients are related to the degree of myopia. Spherical aberrations are the most overriding aberrations of the cornea.展开更多
AIM: To evaluate the effect of incision types for Artisan phakic intraocular lens (PIOL) implantation on ocular higher-order aberrations (HOAs).METHODS: A retrospective review was conducted of the patients who h...AIM: To evaluate the effect of incision types for Artisan phakic intraocular lens (PIOL) implantation on ocular higher-order aberrations (HOAs).METHODS: A retrospective review was conducted of the patients who had undergone Artisan PIOL implantation for the correction of myopia and followed up for at least 6mo. Patients are classified into 2 groups considering the incision type: cornea group with patients undergone clear corneal incision; sclera group with patients undergone sclera tunnel incision. All patients with postoperative astigmatism of under 1 diopter (D) were included to minimize the effect of residual astigmatism on postoperative HOAs. Visual acuity, special equivalents, astigmatism, predictability (±1 D from target refraction), HOAs (coma, trefoil, spherical aberration), and corneal endothelial counts were analyzed preoperatively and 6mo postoperatively.RESULTS: At the postoperative 6mo, all patients of both groups achieved uncorrected visual acuity of 16/20 or better, and significantly decreased the spherical equivalents compared with preoperative values. The predictability of refractive correction was 96% in the former, and 94% in the latter. Unlike the sclera group, preoperative astigmatism decreased significantly in cornea group at postoperative 6mo. The HOAs increased significantly at postoperative 6mo compared to the preoperative values in both groups, and the root mean square (RMS) total and trefoil wavefront aberration of cornea group were significantly higher than those of sclera group.CONCLUSION: Although corneal incision significantly reduces preexisting astigmatism, the postoperative 6mo of total RMS and trefoil aberration change may deteriorate the visual quality after Artisan PIOL implantation.展开更多
It is necessary to know the distribution of the Chinese eye's aberrations in clinical environment to guide high-resolution retinal imaging system design for large Chinese population application.We collected the mo...It is necessary to know the distribution of the Chinese eye's aberrations in clinical environment to guide high-resolution retinal imaging system design for large Chinese population application.We collected the monochromatic wave aberration of 332 healthy eyes and 344 diseased eyes in Chinese population across a 6.0-mm pupil.The aberration statistics of Chinese eyes including healthy eyes and diseased eyes were analyzed,and some differences of aberrations between the Chinese and European race were concluded.On this basis,the requirement for adaptive optics(AO)correction of the Chinese eye's monochromatic aberrations was analyzed.The result showed that a stroke of 20μm and ability to correct aberrations up to the 8th Zernike order were needed for reflective wavefront correctors to achieve near difraction-limited imaging in both groups for a reference wavelength of 550 nm and a pupil diameter of 6.0mm.To verify the:analysis mentioned above,an A0 floodillumination system was established,and high-resolution retinal imaging in vivo was achieved for Chinese eye including both healthy and diseased eyes.展开更多
AIM: To study the dynamic character of aberration between the cornea and the ocular with aging, and to evaluate the symmetry of the aberrations between right and left eye in order to supply the data for clinic to do t...AIM: To study the dynamic character of aberration between the cornea and the ocular with aging, and to evaluate the symmetry of the aberrations between right and left eye in order to supply the data for clinic to do the refractive surgery reasonably. METHODS: This is a comparative case series study. 82 normal cases (164 eyes) including 37 females (74 eyes) and 45 males (90 eyes) were recruited through the routine examinations,Topolyzer and wavefront analysis. The average age was 25.9 +/- 5.0 years old (range 18 to 49 years old), and the mean spherical equivalent (SE) is -3.82 +/- 2.21D (range -1.00 to -6.00D). The changes of aberrations regarding age, the relationship between anterior corneal and total aberrations were analyzed,as well as the symmetry between right and left eyes by using Zernike terms. RESULTS: The Z (3) (1), RMS3 of corneal aberrations, Z (3) (1), Z (4) (0) RMS3 and RMS4 of ocular aberrations had a positive correlation with age. The zernike terms both in corneal and whole eye were significantly correlated between right and left eyes. CONCLUSION: The corneal horizontal coma, ocular horizontal coma and ocular spherical aberrations become to increase at the age of more than 40 years old. The dynamic change of aberration with aging, balance between corneal and ocular, and the symmetric character between left eye and right eye should be designed carefully in the treatment nomogram before the refractive surgery.展开更多
Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes...Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective study.Three consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer reproducibility.The within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were calculated.Results:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism II Z(4,±2)were below 0.634 for posterior corneal surface aberrations.All Sw values for all types of aberrations were equal to or below 0.07μm.Regarding interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,respectively.The ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,respectively.Conclusions:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for trefoil.There was some variability in posterior corneal aberrometric measurements.High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.展开更多
AIM:To evaluate the efficacy of custom-made soft keratoconus(KC)lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.METHODS:Sixty eyes of 42 patients with KC were exam...AIM:To evaluate the efficacy of custom-made soft keratoconus(KC)lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.METHODS:Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone(Toris K)soft silicone hydrogel lenses.Best spectacle-corrected visual acuity(BSCVA)and contact lens-corrected visual acuity(CLCVA)were recorded.Lower-and higher-order corneal aberrations(LOAs and HOAs)were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones.Mesopic pupil diameter and subjective photic phenomena were also assessed.RESULTS:Mean CLCVA was significantly improved compared to BSCVA(P<0.0001).Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses,except for posterior corneal curvature values.In the 4.5 mm central optical zone,all wavefront aberrations decreased significantly after lens fitting(P<0.0001).In contrast,in the 7 mm(peripheral)optical zone,values for HOAs,spherical and residual aberrations,and optical path differences were increased,while LOAs,trefoil,and quadrifoil coefficients were decreased.The rate of photic phenomena was significantly higher in participants with a pupil size>6.00 mm(85.7%).CONCLUSION:Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations.This practical and nonsurgical approach appears to be an effective method for the visual management of KC.展开更多
Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens (Tecnis IOL, AMO) with a modified prola...Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens (Tecnis IOL, AMO) with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity. Methods In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL (Tecnis Z9001, AMO) in one eye and a biconvex spherical surface IOL (CeeOn 911A, AMO) in the other. After 3 months, the following were investigated: best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye (ocular), cornea, and internal plane. Results The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration (Z4^0) was found in the Tecnis group, whereas positive Z4^0 found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group. Conclusions The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.展开更多
Background:Intraocular lens(IOL)calcification is a serious condition that can only be treated by removing the clouded lens.Since explantation bears the risk of complications,it is often deferred until the patient find...Background:Intraocular lens(IOL)calcification is a serious condition that can only be treated by removing the clouded lens.Since explantation bears the risk of complications,it is often deferred until the patient finds the symptoms intolerable.Usually,as the IOL opacifies,visual acuity is minimally affected early on.In this study,we assessed the impact of IOL opacification on optical quality.Methods:We analyzed ten opacified explanted IOLs(Oculentis GmbH).Wavefront aberrations were obtained with a SHSOphthalmic device(Optocraft GmbH),which features a Hartmann-Shack sensor.The root mean square(RMS)of higher-order aberrations(HOAs)was compared.The effect of calcification on image quality was assessed through the Strehl ratio(SR).We detected light scattering with a C-Quant(Oculus GmbH)and expressed it as a straylight parameter.Results:At 2 mm,3mm and 4 mm,the mean RMS(±standard deviation)was 0.033μm(±0.026μm),0.044μm(±0.027),and 0.087μm(±0.049),respectively.The mean SR value was 0.81±0.15 at 3 mm,with four IOLs showing a nearly diffraction-limited performance,but in two explants,opacification precluded reliable measurements.Increased straylight was found in all opacified IOLs with a mean value of 150.2±56.3 deg^(2)/sr at 3 mm.Conclusions:We demonstrated that IOL opacification induces HOAs.However,the RMS remained low,which resulted only in a slight reduction of the SR-derived optical quality.On the other hand,we found a severe straylight elevation in the opacified lenses,which may result in dysphotopsia,such as glare,and subjective complaints,despite good visual acuity.展开更多
Background:The optical quality in progressive keratoconus deteriorates due to ectasia and distortion of the corneal shape and optics.While corneal cross-linking(CXL)aims at stopping disease progression,"CXL-Plus&...Background:The optical quality in progressive keratoconus deteriorates due to ectasia and distortion of the corneal shape and optics.While corneal cross-linking(CXL)aims at stopping disease progression,"CXL-Plus"combines CXL with excimer laser ablation to improve visual function.Central corneal regularization(CCR)represents a therapeutic excimer laser modality specifically designed to smoothen the ectatic corneal shape and to reduce higher-order aberrations(HOA).We set out to compare CXL-Plus,consisting of CXL combined with CCR,with CXL by itself for patients with progressive keratoconus.Methods:Retrospective 2-year matched group analysis of patients who either underwent CXL-Plus{n=28)or CXL as a sole procedure(n=28)for progressive keratoconus.Main outcome parameters were HOA,visual function and tomographic results 12 and 24 months postoperatively.Results:After 12 months,the total HOA root mean square wavefront error was reduced from 0.79±0.30 to 0.40±0.19 pm(CXL-Plus;P<0.0001)and changed from 0.71±0.28 to 0.73±0.36 pm(CXL;P=0.814).Uncorrected distance visual acuity improved from 0.70±0.35 to 0.36±0.29 logMAR(CXL-Plus;P=0.0002)and from 0.65±0.39 to 0.46±0.37 logMAR(CXL;P=0.067),translating to gains of three or more lines in 50%(CXL-Plus)and 36%(CXL)of patients.The steepest keratometry value(Kmax)regressed by 5.84 D(CXL-Plus;P<0.0001)and 0.66 D(CXL;P=0752).For none of the investigated parameters a statistically significant change could be shown between 12 and 24 months.Conclusions:CXL-Plus in the form of a CCR reduces HOA and Kmax more effectively than CXL as a sole procedure.展开更多
基金Supported by Scientific Research Project of Heilongjiang Health Commission,China,No.2020-141.
文摘BACKGROUND Myopia and high myopia are global public health concerns.Patients with high myopia account for 0.5%-5.0%of the global population.AIM To examine diopters,axial length(AL),higher-order aberrations,and other ocular parameters in Chinese children with myopia,to analyze the influence of structural parameters associated with myopia on visual quality,and to provide a theoretical basis for the prevention and treatment of childhood myopia and high myopia.METHODS This study included 195 children aged 6–17 years with myopia.The AL was measured with an ultrasonic ophthalmic diagnostic instrument,and the aberrations,corneal curvature(minimum K1,maximum K2,and average Km),central corneal thickness,anterior chamber depth,and anterior chamber angle were measured using a Sirius three-dimensional anterior segment analyzer.Using a standard formula,the corneal radius of curvature R(337.3/Km)and AL/R values were obtained.RESULTS The diopter of high myopia compared with low-middle myopia was correlated with age and AL(r=-0.336,-0.405,P<0.001),and AL of high myopia was negatively correlated with K1,K2,and Km(r=-0.673,-0.661,and-0.680,respectively;P<0.001),and positively correlated with age and the anterior chamber depth(r=0.214 and 0.275,respectively;P<0.05).AL/R was more closely related to diopter than AL in children with myopia,and 94.4%of children with myopia had an AL/R of>3.00.CONCLUSION The ocular structural parameters of children change because of different diopters.AL/R is more specific and sensitive than AL in evaluating the refractive status of myopia in children.An AL/R of>3.00 may be used as a specific index of myopia in children.There are differences in AL/R between high myopia and low-middle myopia,which can be used for the classification of ametropia.The degree of myopia has a certain influence on higher-order aberrations.
文摘Background: Individualized corneal refractive surgery requires an understanding of the basis of higher-order aberrations before surgery. To investigate the characteristics and distribution of anterior surface wavefront aberrations in patients suitable for corneal refractive surgery. Methods: A total of 121 myopic patients (121 eyes, 18 - 45 years old) who underwent corneal refractive surgery were recruited from January to May 2016 at Affiliated Hospital, Yanbian University. Patients were randomly selected by the Pentacam anterior segment analysis system with a spherical equivalent (SE) of -0.25 to -10.00 D. The corneal anterior aberrations (total higher-order aberration;spherical aberration;Coma;Trefoil) and Q and K values were detected, and a correlation analysis of the relevant parameters was carried out. Results: The root-mean-square (RMS) of the third to sixth order aberrations of the corneal anterior wavefront aberrations at a 6 mm analysis diameter showed a decreasing trend in patients suitable for the corneal refractive surgery, and the RMS of the third order aberrations accounted for 62.92% of the total HOAs. The coma ratio (coma/total cornea higher-order aberrations) was increased with the increasing diopters, while the spherical aberration ratio (spherical aberration/total cornea higher-order aberrations) was not changed. In addition, the spherical aberration was 0.203 ± 0.082 μm (range: 0.061 to 0.503 μm), and the Q30 was -0.19 ± 0.03 (range: -0.58 to 0.31). There were significant differences in the coma aberrations of preoperative corneal anterior surface (3, 1) between the low, middle and high myopia groups (P = 0.013). The spherical equivalent was positively correlated with the corneal coma of the anterior corneal surfaces (R =?-0.241, P = 0.009), and the Q value was positively correlated with the total higher-order aberrations (R = 0.326, P Conclusions: Individual wavefront aberrations on the anterior surfaces of the cornea are comparatively different, and the Zernike coefficients are related to the degree of myopia. Spherical aberrations are the most overriding aberrations of the cornea.
文摘AIM: To evaluate the effect of incision types for Artisan phakic intraocular lens (PIOL) implantation on ocular higher-order aberrations (HOAs).METHODS: A retrospective review was conducted of the patients who had undergone Artisan PIOL implantation for the correction of myopia and followed up for at least 6mo. Patients are classified into 2 groups considering the incision type: cornea group with patients undergone clear corneal incision; sclera group with patients undergone sclera tunnel incision. All patients with postoperative astigmatism of under 1 diopter (D) were included to minimize the effect of residual astigmatism on postoperative HOAs. Visual acuity, special equivalents, astigmatism, predictability (±1 D from target refraction), HOAs (coma, trefoil, spherical aberration), and corneal endothelial counts were analyzed preoperatively and 6mo postoperatively.RESULTS: At the postoperative 6mo, all patients of both groups achieved uncorrected visual acuity of 16/20 or better, and significantly decreased the spherical equivalents compared with preoperative values. The predictability of refractive correction was 96% in the former, and 94% in the latter. Unlike the sclera group, preoperative astigmatism decreased significantly in cornea group at postoperative 6mo. The HOAs increased significantly at postoperative 6mo compared to the preoperative values in both groups, and the root mean square (RMS) total and trefoil wavefront aberration of cornea group were significantly higher than those of sclera group.CONCLUSION: Although corneal incision significantly reduces preexisting astigmatism, the postoperative 6mo of total RMS and trefoil aberration change may deteriorate the visual quality after Artisan PIOL implantation.
基金the National.Key Scientific Instrument and Equipment Devel-opment Project(Grant Nos.2012YQ120080 and 2013YQ49085903)the National Natural Science.Foundation of China(Grant No.61378064)lthe National High Technology Research and Development Program of China(Grant No.2015AA020510).
文摘It is necessary to know the distribution of the Chinese eye's aberrations in clinical environment to guide high-resolution retinal imaging system design for large Chinese population application.We collected the monochromatic wave aberration of 332 healthy eyes and 344 diseased eyes in Chinese population across a 6.0-mm pupil.The aberration statistics of Chinese eyes including healthy eyes and diseased eyes were analyzed,and some differences of aberrations between the Chinese and European race were concluded.On this basis,the requirement for adaptive optics(AO)correction of the Chinese eye's monochromatic aberrations was analyzed.The result showed that a stroke of 20μm and ability to correct aberrations up to the 8th Zernike order were needed for reflective wavefront correctors to achieve near difraction-limited imaging in both groups for a reference wavelength of 550 nm and a pupil diameter of 6.0mm.To verify the:analysis mentioned above,an A0 floodillumination system was established,and high-resolution retinal imaging in vivo was achieved for Chinese eye including both healthy and diseased eyes.
文摘AIM: To study the dynamic character of aberration between the cornea and the ocular with aging, and to evaluate the symmetry of the aberrations between right and left eye in order to supply the data for clinic to do the refractive surgery reasonably. METHODS: This is a comparative case series study. 82 normal cases (164 eyes) including 37 females (74 eyes) and 45 males (90 eyes) were recruited through the routine examinations,Topolyzer and wavefront analysis. The average age was 25.9 +/- 5.0 years old (range 18 to 49 years old), and the mean spherical equivalent (SE) is -3.82 +/- 2.21D (range -1.00 to -6.00D). The changes of aberrations regarding age, the relationship between anterior corneal and total aberrations were analyzed,as well as the symmetry between right and left eyes by using Zernike terms. RESULTS: The Z (3) (1), RMS3 of corneal aberrations, Z (3) (1), Z (4) (0) RMS3 and RMS4 of ocular aberrations had a positive correlation with age. The zernike terms both in corneal and whole eye were significantly correlated between right and left eyes. CONCLUSION: The corneal horizontal coma, ocular horizontal coma and ocular spherical aberrations become to increase at the age of more than 40 years old. The dynamic change of aberration with aging, balance between corneal and ocular, and the symmetric character between left eye and right eye should be designed carefully in the treatment nomogram before the refractive surgery.
基金the Medical and Health Science and Technology Program of Zhejiang Province(2019KY111)Foundation of Wenzhou City Science&Technology Bureau(Y2020037)+1 种基金EYE&ENT Hospital of Fudan University High-level Talents Program(2021318)Clinical Research Plan of SHDC(SHDC2020CR1043B)。
文摘Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective study.Three consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer reproducibility.The within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were calculated.Results:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism II Z(4,±2)were below 0.634 for posterior corneal surface aberrations.All Sw values for all types of aberrations were equal to or below 0.07μm.Regarding interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,respectively.The ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,respectively.Conclusions:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for trefoil.There was some variability in posterior corneal aberrometric measurements.High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.
文摘AIM:To evaluate the efficacy of custom-made soft keratoconus(KC)lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.METHODS:Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone(Toris K)soft silicone hydrogel lenses.Best spectacle-corrected visual acuity(BSCVA)and contact lens-corrected visual acuity(CLCVA)were recorded.Lower-and higher-order corneal aberrations(LOAs and HOAs)were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones.Mesopic pupil diameter and subjective photic phenomena were also assessed.RESULTS:Mean CLCVA was significantly improved compared to BSCVA(P<0.0001).Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses,except for posterior corneal curvature values.In the 4.5 mm central optical zone,all wavefront aberrations decreased significantly after lens fitting(P<0.0001).In contrast,in the 7 mm(peripheral)optical zone,values for HOAs,spherical and residual aberrations,and optical path differences were increased,while LOAs,trefoil,and quadrifoil coefficients were decreased.The rate of photic phenomena was significantly higher in participants with a pupil size>6.00 mm(85.7%).CONCLUSION:Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations.This practical and nonsurgical approach appears to be an effective method for the visual management of KC.
文摘Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens (Tecnis IOL, AMO) with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity. Methods In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL (Tecnis Z9001, AMO) in one eye and a biconvex spherical surface IOL (CeeOn 911A, AMO) in the other. After 3 months, the following were investigated: best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye (ocular), cornea, and internal plane. Results The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration (Z4^0) was found in the Tecnis group, whereas positive Z4^0 found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group. Conclusions The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.
基金supported by an unrestricted research grant from the Klaus Tschira FoundationHeidelberg,Germany.T.Yildirim is funded by the Physician-Scientist Program of the Heidelberg University,Faculty of Medicine.
文摘Background:Intraocular lens(IOL)calcification is a serious condition that can only be treated by removing the clouded lens.Since explantation bears the risk of complications,it is often deferred until the patient finds the symptoms intolerable.Usually,as the IOL opacifies,visual acuity is minimally affected early on.In this study,we assessed the impact of IOL opacification on optical quality.Methods:We analyzed ten opacified explanted IOLs(Oculentis GmbH).Wavefront aberrations were obtained with a SHSOphthalmic device(Optocraft GmbH),which features a Hartmann-Shack sensor.The root mean square(RMS)of higher-order aberrations(HOAs)was compared.The effect of calcification on image quality was assessed through the Strehl ratio(SR).We detected light scattering with a C-Quant(Oculus GmbH)and expressed it as a straylight parameter.Results:At 2 mm,3mm and 4 mm,the mean RMS(±standard deviation)was 0.033μm(±0.026μm),0.044μm(±0.027),and 0.087μm(±0.049),respectively.The mean SR value was 0.81±0.15 at 3 mm,with four IOLs showing a nearly diffraction-limited performance,but in two explants,opacification precluded reliable measurements.Increased straylight was found in all opacified IOLs with a mean value of 150.2±56.3 deg^(2)/sr at 3 mm.Conclusions:We demonstrated that IOL opacification induces HOAs.However,the RMS remained low,which resulted only in a slight reduction of the SR-derived optical quality.On the other hand,we found a severe straylight elevation in the opacified lenses,which may result in dysphotopsia,such as glare,and subjective complaints,despite good visual acuity.
文摘Background:The optical quality in progressive keratoconus deteriorates due to ectasia and distortion of the corneal shape and optics.While corneal cross-linking(CXL)aims at stopping disease progression,"CXL-Plus"combines CXL with excimer laser ablation to improve visual function.Central corneal regularization(CCR)represents a therapeutic excimer laser modality specifically designed to smoothen the ectatic corneal shape and to reduce higher-order aberrations(HOA).We set out to compare CXL-Plus,consisting of CXL combined with CCR,with CXL by itself for patients with progressive keratoconus.Methods:Retrospective 2-year matched group analysis of patients who either underwent CXL-Plus{n=28)or CXL as a sole procedure(n=28)for progressive keratoconus.Main outcome parameters were HOA,visual function and tomographic results 12 and 24 months postoperatively.Results:After 12 months,the total HOA root mean square wavefront error was reduced from 0.79±0.30 to 0.40±0.19 pm(CXL-Plus;P<0.0001)and changed from 0.71±0.28 to 0.73±0.36 pm(CXL;P=0.814).Uncorrected distance visual acuity improved from 0.70±0.35 to 0.36±0.29 logMAR(CXL-Plus;P=0.0002)and from 0.65±0.39 to 0.46±0.37 logMAR(CXL;P=0.067),translating to gains of three or more lines in 50%(CXL-Plus)and 36%(CXL)of patients.The steepest keratometry value(Kmax)regressed by 5.84 D(CXL-Plus;P<0.0001)and 0.66 D(CXL;P=0752).For none of the investigated parameters a statistically significant change could be shown between 12 and 24 months.Conclusions:CXL-Plus in the form of a CCR reduces HOA and Kmax more effectively than CXL as a sole procedure.