Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses

Brito, Pedro; Salgado-Borges, José; Neves, Helena; González-Meijóme, José Manuel; Monteiro, Mariana

doi:10.1016/j.jcrs.2014.07.033

Cited by 51 publications

(74 citation statements)

References 35 publications

(26 reference statements)

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“…Recently, increased light-distortion index or best-fit circle radius of the distortion area have been found after refractive lens exchange with diffractive multifocal IOLs in comparison with monofocal IOL. 25 In our study, the mean halo radius obtained in the monofocal IOL group was similar to the normal mean halo radius reported for phakic eyes for this age group. 18 Figure 3.…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, no significant correlations were found between the light-distortion index or best-fit circle radius and postoperative highcontrast UDVA and CDVA in diffractive multifocal IOLs. 25 However, in the present study, a significant correlation was detected between the halo radius and low-contrast UDVA in the multifocal IOL group. This coincides with the finding that retinal straylight, measured with the C-Quant, was significantly correlated with contrast sensitivity in patients implanted with a multifocal IOL.…”

Section: Discussioncontrasting

confidence: 73%

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Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Puell

Pérez-Carrasco

Hurtado-Ceña

et al. 2015

Journal of Cataract and Refractive Surgery

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PURPOSE:To compare disk halo size in response to a glare source in eyes implanted with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL.SETTING: Rementeria Ophthalmological Clinic, Madrid, Spain.DESIGN: Prospective randomized masked study. METHOD:Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in 39 eyes that had cataract surgery and the bilateral implant of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and lowcontrast (10%) logMAR letter charts. RESULTS:The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. Mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P < .05). Greater halo effects (P < .05) were reported in the multifocal IOL group. Mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 and 0.13 logMAR (P < .01) in the multifocal than in the monofocal IOL group, respectively. A significant positive correlation (r Z 0.72, P < .001) was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group. CONCLUSIONS:The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA. The authors have no commercial or proprietary interests in the devices used in this study or manufacturing companies. J Cataract Refract Surg 2015; -:---Q 2015 ASCRS and ESCRSCurrent diffractive multifocal intraocular lenses (IOLs) provide satisfactory distance, intermediate, and near visual acuity, reducing spectacle dependency.1 However, adverse subjective visual phenomena, such as glare and halos, are often reported by patients with multifocal IOLs, especially when driving at night. 1Theoretical optical design predictions suggest that multifocal IOLs will induce more light scatter than monofocal IOLs.2 In a refractive-diffraction IOL designed to simultaneously yield focused images of near and far objects, 3 forward scattered light from a glare source forms a veil of luminance over the retina.Disk halos form because the out-of-focus image has a larger diameter than the sharp image on the retina. 4 The unwanted effect of the light in the out-of-focus image may be visually disturbing, depending on 2 factors: the distance along the optical axis between these 2 images (the greater the distance between the 2 separate focal points along the optical axis, the greater will be the diffusion or blur circle surrounding the primary focus), and their relative energy distribution (the ene...

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 73%

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Puell

Pérez-Carrasco

Hurtado-Ceña

et al. 2015

Journal of Cataract and Refractive Surgery

View full text Add to dashboard Cite

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“…Compared to our previous study [14] we did not measure binocular functions of LD and CS in the present study. This does not reflect the actual viewing conditions of the patients, but we aimed to maximize the potential changes to be observed and we know that they would be more likely detected under monocular conditions, as binocular summation will tend to improve the results of LD [14, 37] and CS [38]. We also aimed to explore the correlations with HOA specific to each eye, which forced us to do follow a monocular analysis in this part of the study.…”

Section: Discussionmentioning

confidence: 99%

Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results

Santolaria-Sanz

Cerviño

González-Meijóme

2016

Journal of Ophthalmology

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Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.

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“…19 In summary, the present study shows that the LDA might be a useful device in evaluating the light distortion, providing a comprehensive number of metrics to characterize the condition, and being robust to different sources of error in young healthy eyes. Considering that postsurgical or diseased patients could present significantly higher values of light distortion, the results obtained in the present study cannot be directly extrapolated to those specific populations.…”

Section: Discussionmentioning

confidence: 72%

“…The present device has been shown to be sensitive to differences in light distortion induced by IOL with different optical designs, 19 and multifocal contact lenses (unpublished results). Another relevant result is the relationship between the intensity of the central source and the LDI.…”

Section: Discussionmentioning

confidence: 81%

Validation of a method to measure light distortion surrounding a source of glare

et al. 2015

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Our objective was to validate a new device dedicated to measure the light disturbances surrounding bright sources of light under different sources of potential variability. Twenty subjects were involved in the study. Light distortion was measured using an experimental prototype (light distortion analyzer, CEORLab, University of Minho, Portugal) comprising twenty-four LED arrays panel at 2 m. Sources of variability included: intrasession and intersession repeated measures, pupil size (3 versus 6 mm), defocus (+0.50 ) correction for the working distance, angular resolution (15 deg versus 30 deg), temporal stimuli presentation, and pupil size. Size, shape, location, and irregularity parameters have been obtained. At a low speed of presentation of the stimuli, changes in angular resolution did not have an effect on the results of the parameters measured. Results did not change with pupil size. Intensity of the central glare source significantly influenced the outcomes. Examination time was reduced by 30% when a 30 deg angular resolution was explored instead of 15 deg. Measurements were fast and repeatable under the same experimental conditions. Size and shape parameters showed the highest consistency, whereas location and irregularity parameters showed lower consistency. The system was sensitive to changes in the intensity of the central glare source but not to pupil changes in this sample of healthy subjects

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Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 51 publications

References 35 publications

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses

Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results

Validation of a method to measure light distortion surrounding a source of glare

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