Femtosecond laser fabrication of 3D templates for mass production of artificial compound eyes

Compound eyes are unique optical imaging systems that consist of numerous separate light-sensitive units(ommatidia).Attempts have been made to produce artificial compound eyes via advanced 3 D nanotechnologies.Among them,femtosecond laser direct writing(FsLDW)technology has emerged as an effective strategy due to its distinct advantages in 3 D designable and high precision fabrication capability.However,the point-by-point scanning process results in a very low fabrication efficiency,limiting the practical applications of the FsLDW technology.To solve this problem,we propose a high-efficiency method for the mass production of 3 D artificial compound eyes using a photopolymer template fabricated by FsLDW.The resultant 3 D SU-8 compound eye templates could be used to replicate polydimethylsiloxane(PDMS)compound eyes many times(over 50 times)with a highly improved efficiency(nearly 20 times higher than the efficiency of direct fabrication using the point-by-point FsLDW).The PDMS replicas showed good focusing and imaging performances.We anticipate that this method may serve as an enabler for the mass production of 3 D artificial compound eyes and promote their practical applications in the near future.

Selective laser trabeculoplasty in pseudophakic and phakic eyes:a prospective study

AIM：To compare the efficacy of selective laser trabeculoplasty（SLT） in replacing medical therapy in pseudophakic and phakic eyes.METHODS：Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication.Of 38 pseudophakic eyes were matched with 38 phakic eyes.SLT was offered as a way to decrease medication while maintaining the same low eye pressure.SLT was performed over 360°,at 3ns,spotsize 400 μm,100 spots.Data [intraocular pressure（IOP）,number of medications needed] were measured at 1h,1wk,1,3,6 and 12 mo.An independent-samples t-test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications.Chi-squared analysis was performed to investigate proportions of fast,slow and non-responders.RESULTS：The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group（38 eyes） and 13.51±3.06 mm Hg in the pseudophakic group（38 eyes）（P〉0.05）.This changed little after SLT and IOP lowering effect was comparable between the two groups.Main aim however was to lower the amount of medication needed.In the phakic group medication lowered from 1.29±0.62 at baseline,to 0.15±0.46 after 12mo;a reduction of 88.37%.In the pseudophakic group,used medication changed from 1.71±1.04,to 0.41±0.61;a 76.02% reduction.The differences were not statistically significant at any time point（P〉0.05）.IOP lowering occurred slightly faster in thepseudophakic group（50% of patients after one week） than in the phakic group（68% of patients after more than 4wk）.The difference was not significant（P〉0.05）.CONCLUSION：IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.

Corneal neuromediator profiles following laser refractive surgery

Laser refractive surgery is one of the most commonly performed procedures worldwide.In laser refractive surgery,Femtosecond Laser in Situ Keratomileusis and Refractive Lenticule Extraction have emerged as promising alternatives to microkeratome Laser in Situ Keratomileusis and Photorefractive Keratectomy.Following laser refractive surgery,the corneal nerves,epithelial and stromal cells release neuromediators,including neurotrophins,neuropeptides and neurotransmitters.Notably,nerve growth factor,substance P,calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve regeneration.Alterations in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult induced.In this review,we will discuss the(1)Functions of neuromediators and their physiological and clinical significance;(2)Changes in the neuromediators following various laser refractive surgeries;(3)Correlation between neuromediators,ocular surface health and corneal nerve status;and(4)Future directions,including the use of neuromediators as potential biomarkers for ocular surface health following laser refractive surgery,and as adjuncts to aid in corneal regeneration after laser refractive surgery.

Comparison of the femtosecond Laser and mechanical microkeratome for flap cutting in LASIK

· AIM: To compare refractive results, higher-order aberrations(HOAs), contrast sensitivity and dry eye after laser in situ keratomileusis(LASIK) performed with a femtosecond laser versus a mechanical microkeratome for myopia and astigmatism.·METHODS: In this prospective, non-randomized study,120 eyes with myopia received a LASIK surgery with the Visu Max femtosecond laser for flap cutting, and 120 eyes received a conventional LASIK surgery with a mechanical microkeratome. Flap thickness, visual acuity, manifest refraction, contrast sensitivity function(CSF) curves,HOAs and dry-eye were measured at 1wk; 1, 3, 6mo after surgery.·RESULTS: At 6mo postoperatively, the mean central flap thickness in femtosecond laser procedure was113.05 ±5.89 μm(attempted thickness 110 μm), and148.36 ±21.24 μm(attempted thickness 140 μm) in mechanical microkeratome procedure. An uncorrected distance visual acuity(UDVA) of 4.9 or better was obtained in more than 98% of eyes treated by both methods, a gain in log MAR lines of corrected distance visual acuity(CDVA) occurred in more than 70% of eyes treated by both methods, and no eye lost ≥1 lines of CDVA in both groups. The difference of the mean UDVA and CDVA between two groups at any time post-surgery were not statistically significant(P 】0.05). The postoperative changes of spherical equivalent occurred markedly during the first month in both groups. The total root mean square values of HOAs and spherical aberrations in the femtosecond treated eyes were markedly less than those in the microkeratome treated eyes during 6mo visit after surgery(P 【0.01). The CSF values of the femtosecond treated eyes were also higherthan those of the microkeratome treated eyes at all space frequency(P 【0.01). The mean ocular surface disease index scores in both groups were increased at 1wk, and recovered to preoperative level at 1mo after surgery. The mean tear breakup time(TBUT) of the femtosecond treated eyes were markedly longer than those of the microkeratome treated eyes at postoperative 1, 3mo(P 【0.01).·CONCLUSION: Both the femtosecond laser and the mechanical microkeratome for LASIK flap cutting are safe and effective to correct myopia, with no statistically significant difference in the UDVA, CDVA during 6mo follow-up. Refractive results remained stable after 1mo post-operation for both groups. The femtosecond laser may have advantages over the microkeratome in the flap thickness predictability, fewer induced HOAs, better CSF,and longer TBUT.

Effect of Laser in situ Keratomileusis on Accommodation

The accommodative function before and after laser in situ keratomileusis （LASIK） was observed, and the effect of LASIK on accommodation was investigated. In a prospective clinical trial, 48 myopic patients （96 eyes） subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology （China） from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component （HFC） of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes （P〉0.05）, but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio （A/S） after operation （P〈0.01）, and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance＇s change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.

Human eye ocular component analysis for refractive state and refractive surgery

AIM： To analyze the clinical factors influencing the human vision corrections via the changing of ocular components of human eye in various applications; and to analyze refractive state via a new effective axial length.METHODS： An effective eye model was introduced by the ocular components of human eye including refractive indexes, surface radius（r1, r2, R1, R2） and thickness（t, T） of the cornea and lens, the anterior chamber depth（S1） and the vitreous length（S2）. Gaussian optics was used to calculate the change rate of refractive error per unit amount of ocular components of a human eye（the rate function M）. A new criterion of myopia was presented via an effective axial length.RESULTS： For typical corneal and lens power of 42 and 21.9 diopters, the rate function Mj（j=1 to 6） were calculated for a 1% change of r1, r2, R1, R2, t, T（in diopters） M1=＋0.485, M2=-0.063, M3=＋0.053, M4=＋0.091, M5=＋0.012, and M6=-0.021 diopters. For 1.0 mm increase of S1 and S2, the rate functions were M7=＋1.35, and M8=-2.67 diopter/mm, respectively. These rate functions were used to analyze the clinical outcomes in various applications including laser in situ keratomileusis surgery, corneal cross linking procedure, femtosecond laser surgery and scleral ablation for accommodation.CONCLUSION： Using Gaussian optics, analytic formulas are presented for the change of refractive power due to various ocular parameter changes. These formulas provide useful clinical guidance in refractive surgery and other related procedures.

Navigation technology/eye-tracking in ophthalmology:principles,applications and benefits-a narrative review

Navigation technology in ophthalmology,colloquially called“eye-tracking”,has been applied to various areas of eye care.This approach encompasses motion-based navigation technology in both ophthalmic imaging and treatment.For instance,modern imaging instruments use a real-time eye-tracking system,which helps to reduce motion artefacts and increase signal-to-noise ratio in imaging acquisition such as optical coherence tomography(OCT),microperimetry,and fluorescence and color imaging.Navigation in ophthalmic surgery has been firstly applied in laser vision corrective surgery and spread to involve navigated retinal photocoagulation,and positioning guidance of intraocular lenses(IOL)during cataract surgery.It has emerged as one of the most reliable representatives of technology as it continues to transform surgical interventions into safer,more standardized,and more predictable procedures with better outcomes.Eye-tracking is essential in refractive surgery with excimer laser ablation.Using this technology for cataract surgery in patients with high preoperative astigmatism has produced better therapeutic outcomes.Navigated retinal laser has proven to be safer and more accurate compared to the use of conventional slit lamp lasers.Eye-tracking has also been used in imaging diagnostics,where it is essential for proper alignment of captured zones of interest and accurate follow-up imaging.This technology is not routinely discussed in the ophthalmic literature even though it has been truly impactful in our clinical practice and represents a small revolution in ophthalmology.

Influence of transverse mode on retinal spot size and retinal injury effect:A theoreticalan alysis on 532-nm laser

The fundamental transverse mode(TEM00)is preferable for experimental and theoretical study on the laser-induced retinal injury effect,for it can produce the minimal retinal image andestablish the most strict laser safety standards.But actually lasers with higher order mode werefrequently used in both earlier and recent studies.Generally higher order mode leads to largerretinal spot size and so higher damage threshold,but there are few quantitative analyses on thisproblem.In this paper,a four-surface schematic eye model is established for human and macaque.The propagation of 532-nm laser in schematic eye is analyzed by the ABCD law of Gaussianoptics.It is shown that retinal spot size increases with laser transverse mode order.For relativelower mode order,the retinal spot diameter will not exceed the minimum laser-induced retinallesion(25~30μm in diameter),and so has little effect on retinal damage threshold.While forhigher order mode,the larger'retinal spot requires more energy to induce injury and so the damage threshold increases.When beam divergence is lowered,the retinal spot size decreasescorrespondingly,so the efect of mode order can be compensated.The retinal spot size of macaqueis slightly smaller than that of human and the ratio bet ween them is independent of mode order.We conclude that the laser mode order has significant influence on retinal spot size but limitedinfluence on the retinal injury ffect.

Diode Laser Cyclophotocoagulation in the Management of Pain and Intraocular Pressure Control in Patients with Terminal Glaucoma--Six Years’Experience

Objective: This study aims to describe the experience with diode laser cyclophotocoagulation in the control of intraocular pressure and resolution of pain in patients with refractory glaucoma. Methods: Retrospective study. 64 eyes of 60 patients who underwent cyclophotocoagulation between January 2008 and March 2014. Evaluation of the pre- and post-operative intraocular pressure, the control of ocular pain, the number of anti-glaucoma drugs used in pre- and post-intervention, the rate of complications and the success rate. Results: There was an overall success rate of 81.3%, with 9 eyes needing a second intervention. There was a mean reduction of 52.6% of the preoperative mean intraocular pressure of 41.25 to 19.56 mmHg at 12 months observation (p < 0.001). There was also a statistically significant reduction in the number of anti-glaucoma drugs used from 3.19 to 2.01 per eye and the resolution of pain in 75% of patients. Conclusions: cyclophotocoagulation is an effective procedure, with an expected positive impact on quality of life of patients as a result from the decreased number of anti-glaucoma drugs, sustained intraocular pressure reduction and resolution of pain.

Measuring Method of Radius of Curvature Based on Dual-Frequency Laser Interferometer

In order to achieve high-accuracy measurement of radius of curvature of optical sphere, ultra-high accuracy radius of curvature testing device is developed by dual-frequency laser interferometer and Fizeau interferometer based on cat’s eye and confocal method. Through analyzing the error source models of radius of curvature testing, optical configuration of the testing device has been optimized. Precise environment control and real-time monitoring system is also established to reduce the errors caused by environment. Through the above processes, the radius of curvature measurement relative accuracy is better than 2 ppm. One optical sphere, R88.5 mm, test aperture 59 mm, has been tested. Testing result is 88499.465 ± 0.176 μm, meeting the design requirement. The method has high accuracy and practical advantages.

Adjustable-free and movable Nd:YVO_(4) thin disk laser based on the telecentric cat's eye cavity

In this paper, we propose and demonstrate an adjustable-free and movable Nd:YVO_(4)thin disk laser based on the telecentric cat’s eye cavity. We design a V-shaped laser cavity containing two reflectors with Nd:YVO_(4)thin disks as the gain medium.The experimental results from the traditional plane-plane cavity, plane-telecentric cat’s eye cavity, and double telecentric cat’s eye cavity are compared. They show that plane-telecentric cat’s eye cavity laser can keep operating at the adjustablefree range of -6° to +6°, which is up to 60 times better than that of traditional plane-plane cavity. In the double telecentric cat’s eye case, the adjustable-free range is improved to-13° to +13°. Additionally, in the case of the double telecentric cat’s eye cavity, the output telecentric cat’s eye can achieve free movement within the horizontal range of ±20 mm.

Correlation between Post-LASIK Starburst Symptom and Ocular Wavefront Aberrations

Monochromatic aberrations in post laser in-situ keratomileusis （LASIK） eyes are measured. The data are categorized into reference group and starburst group according to the visual symptoms. Statistic analysis has been made to find the correlation between the ocular wavefront aberrations and the starburst symptom. The rms aberrations of the 3rd and 4th orders for the starburst group are significantly larger than those for the reference group. The starburst symptom shows a strong correlation with vertical coma, total coma, spherical aberrations. For 3-mm pupil size and 5.8-mm pupil size, the modulation transfer function （MTF） of the starburst group are lower than those of the reference group, but their visual acuities are close. MTF and PSF analyses are made for two groups, and the results are consistent with the statistical analysis, which means the difference between the two groups is mainly due to the third- and fourth-order Zernike aberrations.

EXCIMER LASER PHOTOREFRACTIVE KERATECTOMY FOR MYOPIA IN CHINA A REPORT OF 750 EYES WITH A 6-MONTH FOLLOW-UP

A total of 750 six-month follow-up records of myopia treated with excimer laser photorefractive keratectomy (PRK) were analyzed. By 6 months, in group 1 (up to-6.00D, 587 eyes), uncorrected visual acuity was improved to 20 / 20 or better in 86.7% of treated eyes and 95.4% fell into the range of refraction of±1.00D. In group 2 (-6.25D to -11.00D, 163 eyes), 74.5% of treated eyes had uncorrected visual acuity of 20 / 20 or better and 89.4% of the eyes were within ±1.00D. The designed predictability of the two groups was the same (P>0.1). The refractive stability from 3 to 6 months between the two groups was not statistically different, and no severe complications were observed in these two groups. The excimer laser PRK for correcting myopia up to -11.00D appears to be effective, predictable, stable and safe in this study. The ideal outcome may result from the precise ablation quality of excimer laser, its computerized surgical manipulation and an appropriate postoperative management including detection of refractive indices by conical topography and modulation by steroid.

Diode-pumped single frequency Tm,Ho:YLF laser at room temperature

A diode-pumped single frequcncy Tm,Ho：YLF laser operating at an eye-safe wavelength of 2 μm has been developed. Temperature of the laser crystal was controlled at room temperature with a thermoelectric cooler. The line-width narrowing elements were two solid uncoated fused silica etalons whose thicknesses were 1 and 0.1 mm, respectively. Continuous wave single frequency power of 113 mW was obtained.

Optical study on the vision correction and supernormal vision based on the wave-front aberrations of human eye

In this paper we present the recent research results in the field of vision correction and supernormal vision according to the actual measurements of the wave-front aberrations and the corneal surface topography,the clinical detection of the visual function and the laser corneal refractive surgery,and the optimization of the optical system. These include the features of the aberrations of human eye with different pupil sizes,different fields of view and temporal accommodation,the influence of the polychromatic illumination of the visible wavelength on the supernormal vision,and the effect of the existing laser corneal refractive surgery on the wave-front ab-errations of the eye. It is shown that the wave-front aberration of human eye is of temporal variation and of synthesis with multi impact factors. To achieve super-normal vision,an optimum engineering data for the customized laser corneal sur-gery should be firstly acquired,which may involve the dynamic free-form optical surface. Although the myopia can be corrected by the laser in situ keratomileusis(LASIK) in a certain degree,it brings about negative effects under scotopic condi-tions.

Holographic laser fabrication of 3D artificial compoundμ-eyes

The demand for fast optical image acquisition without movable optical elements(e.g.,for self-driving car technology)can be met using bioinspired 3D compound eyes.3D laser processing strategies enable designable 3D structuring but suffer from low fabrication efficiency,which significantly limits their applications in producing complex 3D optical devices.Herein,we demonstrate a versatile yet simple wet-etching-assisted holographic laser fabrication method for the development of 3D compound eyes.Artificial compoundμ-eyes can be readily fabricated by programming a 3D spot array for the parallel ablation of a curved fused silica surface,followed by controllable etching in a hydrofluoric(HF)acid solution.A 3D-concave-lens array made on a curved surface over an area of 100μm cross-section with each lenslet of 10μm radius was fabricated with high fidelity and excellent imaging/focusing quality.The resultant 3D-concave-lens can serve as a hard template for the mass production of soft compound eyes through soft lithography.Additionally,using a generative adversarial network(GAN)-based deep learning algorithm,image restoration was conducted for each lenslet,which retained a large field of view and significantly improved image quality.This method provides a simple solution to the requirements of compoundμ-eyes required by Industry 4.0.

Small incision lenticule extraction (SMILE) history, fundamentals of a new refractive surgery technique and clinical outcomes

This review summarizes the current status of the small incision lenticule extraction(SMILE)procedure.Following the early work by Sekundo et al.and Shah et al.,SMILE has become increasingly popular.The accuracy of the creation of the lenticule with the VisuMax femtosecond laser(Carl Zeiss Meditec)has been verified using very high-frequency(VHF)digital ultrasound and optical coherence tomography(OCT).Visual and refractive outcomes have been shown to be similar to those achieved with laser in situ keratomileusis(LASIK),notably in a large population reported by Hjortdal,Vestergaard et al.Safety in terms of the change in corrected distance visual acuity(CDVA)has also been shown to be similar to LASIK.It was expected that there would be less postoperative dry eye after SMILE compared to LASIK because the anterior stroma is disturbed only by the small incision,meaning that the anterior corneal nerves should be less affected.A number of studies have demonstrated a lower reduction and faster recovery of corneal sensation after SMILE than LASIK.Some studies have also used confocal microscopy to demonstrate a lower decrease in subbasal nerve fiber density after SMILE than LASIK.The potential biomechanical advantages of SMILE have been modeled by Reinstein et al.based on the non-linearity of tensile strength through the stroma.Studies have reported a similar change in Ocular Response Analyzer(Reichert)parameters after SMILE and LASIK,however,these have previously been shown to be unreliable as a representation of corneal biomechanics.Retreatment options after SMILE are discussed.Tissue addition applications of the SMILE procedure are also discussed including the potential for cryo-preservation of the lenticule for later reimplantation(Mohamed-Noriega,Angunawela,Lim et al.),and a new procedure referred to as endokeratophakia in which a myopic SMILE lenticule is implanted into a hyperopic patient(Pradhan et al.).Finally,studies reporting microdistortions in Bowman’s layer and corneal wound healing responses are also described.

Effects of HepⅡ domain peptides Ⅴ of fibronectin on corneal permeability, endothelial cells, intraocular pressure and morphology of trabecular meshwork in rats

Background Trabecular meshwork （TM） cell volume may be an important determinant of aqueous humor outflow in the eye. This study aimed to evaluate the role of Hepll domain peptides V on corneal permeability, corneal endothelial cells, intraocular pressure （lOP） and morphology of trabecular meshwork in rats. Methods The lOP of rat eyes was measured before and 3, 5, 7 and 8 hours after topical delivery of Hepll domain peptides V through intracameral injections. The peptide＇s concentration in aqueous humor was assessed by high performance liquid chromatography （HPLC）. The shape and density of endothelial cells were observed by laser confocal microscopy 8 hours, 3 and 14 days after intracameral injections of Hepll domain peptides V. The morphological changes in TM of rat eyes were assessed by transmission electron microscopy （TEM）. Results Intracameral injection of Hepll domain peptides V significantly （P 〈0.001） decreased lOP by （5.71±2.10） mmHg in rats at 5 hours after injection. There were no obvious changes of the shape and the density of corneal endothelial cells. In addition, morphological changes in the TM of rats were observed including the expansion of intercellular spaces in the juxtacanalicular meshwork, removal of extracellular material, cellular relaxation, and cytoskeleton reorganization. Conclusions Hepll domain peptides V could not penetrate cornea and was safe to corneal endothelial cells. Hepll domain peptides V could significantly decrease lOP in rat probably by disorganizing actin cytoskeleton and cell-junction in the TM.