Visual Performance of a Polynomial Extended Depth of Focus Intraocular Lens

Purpose: To clinically evaluate a new extended depth of focus intraocular lens (ISOPURE, PhysIOL) with optic design modification based on a unique polynomial concept to improve intermediate vision while keeping the quality of distance vision equal to a monofocal lens. Methods: 18 patients (11 female, 7 male, mean age of 69.4 years) with bilateral cataract and regular corneal astigmatism ≤ 1.0 D underwent bilateral cataract surgery with ISOPURE implantation. Patients were followed for up to 6 months. Measured parameters were uncorrected (UDVA) and corrected distance visual acuity (CDVA), uncorrected (UIVA) and distance-corrected intermediate visual acuity at 80 cm and 66 cm (DCI80VA, DCI66VA) subjective refraction, defocus curve, tolerance of cylinder induction, and contrast sensitivity. The data from all implanted eyes (all-eyes) and a subset only including the first eye implanted for each patient were analysed. Results: The mean manifest refraction spherical equivalent (MRSE) decreased from 1.05 D pre-operatively to ?0.15 D at the 4 - 6 month assessment, with 80.6% of eyes within ±0.50 D of emmetropia. At the final follow-up, mean (SD) monocular CDVA was ?0.06 (0.04) logMAR, DCI80VA was 0.18 (0.08) logMAR and DCI66VA was 0.27 (0.13) logMAR. Despite a cylinder induction of ?0.50 D, uncorrected distance visual acuity of 0.02 logMAR was still achieved. Conclusion: The ISOPURE intraocular lens provides excellent distance corrected visual acuity for far and intermediate distances along with high contrast sensitivity and good tolerance of residual refractive cylinder.

Combined application of extended depth of field imaging, image stitching and polarized microscopy techniques in identification of Spatholobus suberectus

Objective:As traditional techniques for microscopic identification of Chinese medicines currently lack objective and high-quality reference images,here we developed a systemic procedure to be used in microscopic identification of Chinese medicines,which would lead to more objective,effective and accurate identification process.Methods:Spatholobi Caulis(Jixueteng in Chinese)was used as the specimen in the development of such procedure.Jixueteng samples were microscopically examined in bright-and dark-field microscopy.Microscopic images were obtained by regular,EDF,and image stitching techniques.Results:The microscopic images of the characteristics in pulverized Jixueteng were captured,thanks to EDF imaging and image stitching techniques which allowed the detailed and full sighting of each characteristic to be obtained simultaneously.Different layers in anatomical transverse section,including cork,phelloderm,cortex,phloem,cambium,xylem and pith,were distinctively observed.Moreover,by comparing images of bright-and dark-field microscopy,birefringent and non-birefringent components could readily be distinguished.Conclusion:With application of the developed procedure,high-definition,panoramic and microscopic images were acquired,which could be used as the reference images for microscopic identification of Chinese medicines.

Design of double-zone aspheric diffractive intraocular lens with extended depth of focus

A double-zone aspheric diffractive intraocular lens （IOL） was designed and manufactured aiming to regain a continuous range of clear vision for pseudophakic presbyopia. After obtaining the IOL structure parameters through optimization based on an aphakic model eye, its imaging performances were analyzed in the model eye. The modulation transfer function at 50 cycles/mm remained above 0.29 within ±5° field of view for object distance ranging from 6 to 0.66 m. In addition, the imaging qualities are robust for pupil changes, polychromatic light, and different corneal asphericities. The manufactured IOL exhibits the abilitv to extend depth of focus.

Retinal image quality with multifocal, EDoF, and accommodative intraocular lenses as studied by pyramidal aberrometry

BackgroundTo study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-based aberrometer.MethodsThis study included 194 eyes implanted with: (a) 19 AcrySof SA60AT (control group);(b) 19 Miniwell;(c) 24 LENTIS Mplus LS-313 MF30;(d) 33 LENTIS Mplus LS-313 MF15;(e) 17 AkkoLens Lumina;(f) 31 AT LISA Tri 839MP;(g) 20 Precizon Presbyopic;(h) 20 AcrySof IQ PanOptix;(i) 11 Tecnis Eyhance. Main outcome measures were PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square (RMS), low-order aberration (LOA) and high-order aberration (HOA) RMS measured by PWS aberrometer.ResultsAT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0- and 4.0-mm pupil size (0.52 ± 0.14 and 0.31 ± 0.10;P < 0.05), followed by SA60AT (0.41 ± 0.11 and 0.28 ± 0.07) and PanOptix (0.4 ± 0.07 and 0.26 ± 0.04). AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.004). Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.002). Total RMS, LOA RMS, HOA RMS, PSF Strehl ratio and PSFw2 varied significantly between the studied groups (P < 0.001).ConclusionsFar distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens. AT LISA Tri, SA60AT and PanOptix showed the highest values of far distance retinal image quality, while the lowest PSFw2 Strehl ratios were displayed by Miniwell, Mplus MF30 and Precizon Presbyopic.

Retinal image quality with multifocal,EDoF,and accommodative intraocular lenses as studied by pyramidal aberrometry

Background:To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function(PSF)Strehl ratio using a pyramidal wavefront sensor(PWS)-based aberrometer.Methods:This study included 194 eyes implanted with:(a)19 AcrySof SA60AT(control group);(b)19 Miniwell;(c)24 LENTIS Mplus LS-313 MF30;(d)33 LENTIS Mplus LS-313 MF15;(e)17 AkkoLens Lumina;(f)31 AT LISA Tri 839MP;(g)20 Precizon Presbyopic;(h)20 AcrySof IQ PanOptix;(i)11 Tecnis Eyhance.Main outcome measures were PSF Strehl ratio,PSF Strehl ratio excluding second-order aberrations(PSFw2),total root mean square(RMS),low-order aberration(LOA)and high-order aberration(HOA)RMS measured by PWS aberrometer.Results:AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0-and 4.0-mm pupil size(0.52±0.14 and 0.31±0.10;P<0.05),followed by SA60AT(0.41±0.11 and 0.28±0.07)and PanOptix(0.4±0.07 and 0.26±0.04).AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.004).Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm(P<0.0001)and 4.0 mm(P=0.002).Total RMS,LOA RMS,HOA RMS,PSF Strehl ratio and PSFw2 varied significantly between the studied groups(P<0.001).Conclusions:Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens.AT LISA Tri,SA60AT and PanOptix showed the highest values of far distance retinal image quality,while the lowest PSFw2 Strehl ratios were displayed by Miniwell,Mplus MF30 and Precizon Presbyopic.

The effects of premium intraocular lenses on presbyopia treatments

Background:Presbyopia has become a global disease affecting the world's aging population.Among various treatments,cataract extraction and intraocular lens(IOL)implantation have become the most popular and common methods of presbyopia correction.During the twentieth century,IOLs have underwent significant innovation and advancements to meet the patients'high demands for functional vision at all distances.Main Text:To meet the increasing needs for excellent near and intermediate vision for daily activities,some premium IOLs with more than one focus have been developed,for example,the refractive MfIOLs,diffractive MfIOLs,extended depth of field(EDOF)IOLs,and accommodating IOLs(AIOLs)were introduced to meet this need.In addition,the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia.When selecting the MfIOLs,the IOLs'features,patients’characteristics,preoperative eye conditions,and treatment expectations should be considered.Conclusions:In this review,we focus on the multifocal IOLs(MfIOLs)commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes.More evidence-based studies are required to provide guidelines for MfIOL selection,provide maximum visual benefits,and develop personalized visual solutions in the future.