Refraction and defocus curves in eyes with monofocal and multifocal intraocular lenses

Rodríguez‐Vallejo, Manuel; Burguera, Noemí; Rocha‐de‐Lossada, Carlos; Aramberri, Jaime; Fernández, Joaquín

doi:10.1016/j.optom.2023.01.005

Cited by 7 publications

(4 citation statements)

References 45 publications

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“…In this study, we developed and tested a new protocol to measure mesopic subjective refraction (Night Rx protocol). The use of protocols in the visual examination of refractive errors is important to ensure accurate measurement and correction of refractive errors 13 , 16 , 17 . By following established protocols, clinicians can ensure that all aspects of the examination are performed consistently and thoroughly, reducing the risk of errors or oversights, leading to improved visual outcomes for patients.…”

Section: Discussionmentioning

confidence: 99%

Validation of a method to assess night myopia in a clinical setting

Gené-Sampedro,

Basulto Marset,

Monsálvez Romin

et al. 2024

Sci Rep

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A study was conducted with 115 subjects who regularly drove at night to validate a refraction protocol for detecting refractive visual changes from daytime to nighttime conditions. Objective and subjective refractions were performed in both photopic and mesopic conditions, with a dark adaptation period before the mesopic subjective refraction. The results showed that in mesopic conditions, visual acuity decreased by 0.2 logMAR units on average (p < 0.01), and there was a myopic refractive shift of − 0.36 ± 0.20 D (p < 0.01). Most subjects (92.2%) exhibited a myopic refractive shift of at least 0.12 D. Compensation of refractive shift improved mesopic visual acuity by 0.06 logMAR on average (p < 0.01) and higher refractive shifts showed higher improvement. Night Rx was preferred by 82.1% of subjects with myopic refractive shift. Gender and age did not significantly affect the refractive shift, although myopes showed a higher shift compared to emmetropes (p < 0.01). The refractive shift remained stable over time when the time slot of the day did not change (p < 0.01). Night Rx protocol proved to be a robust and accurate method for identifying drivers with refractive changes when transitioning from photopic to mesopic conditions. The high prevalence and inter-individual variability of Rx shift highlight the need of customized refraction.

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Section: Discussionmentioning

confidence: 99%

Validation of a method to assess night myopia in a clinical setting

Gené-Sampedro,

Basulto Marset,

Monsálvez Romin

et al. 2024

Sci Rep

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“…Therefore, in this work, we assessed the optical performance of eyes with different values of SA by means of experimental TF-MTF curves, obtained with a customized visual simulator based on adaptive optics. This system is widely accepted as a useful tool for assessing the visual performance of IOLs and aiding in clinical decisions [38]. Through the experimental TF-MTF and image simulation, we have demonstrated that the FEMTIS Comfort IOL does not behave equally in eyes with positive and negative induced values of SA, and this discrepancy would be reflected in the results of cataract surgery performed on eyes with prior myopic and hyperopic refractive surgery.…”

Section: Discussionmentioning

confidence: 92%

Optical Performance of a Segmented Extended-Depth-of-Focus Intraocular Lens under the Influence of Different Values of Spherical Aberration Generated by Refractive Surgery

Salvá¹,

García²,

García-Delpech³

et al. 2023

JCM

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Background: Corneal refractive surgery induces high-order aberrations, specifically spherical aberration (SA). These aberrations can have implications when patients later develop cataracts and require the implantation of multifocal intraocular lenses (MIOLs). MIOLs with asymmetric designs pose challenges in predicting outcomes, particularly in these cases. The aim of this study was to evaluate how different values of SA, resulting from various types of refractive surgeries, affect the optical performance of the FEMTIS Comfort intraocular lens. Methods: The through-focus modulation transfer function (TF-MTF) curve and high-contrast images of tumbling E were used as parameters to assess the optical performance of the MIOL. These parameters were measured using an adaptive optics visual simulator. Results: Increasingly negative values of SA make the MIOL more bifocal, moderating its extended-depth-of-focus characteristic. Conversely, higher positive SA values cause the TF-MTF curve to shift towards positive vergences, leading to worsened distance vision in the +1.00 to +2.00 D range, but improved vision in the +0.50 D to +1.00 D range. Conclusions: Assessing SA in patients prior to implanting MIOLs with asymmetric designs is necessary for predicting outcomes and making informed decisions based on the visual requirements of patients.

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“…Historically, this is reminiscent of the Irvine-Francis J-cannula published by the authors themselves in 2003, using left-handed and right-handed cannulae for this purpose. 2 This cannula had its irrigating port directly alongside the aspirating port, facilitating safe loosening and removal of the subincisional cortex.…”

Section: Comment On: Thoughts About the Cortexmentioning

confidence: 99%

“…To make the ophthalmology community aware about the problem related to multifocal and EDOF IOLs and automated refraction was our main purpose, and the method suggested by Rodriguez-Vallejo et al provides an excellent and reproducible way to obtain accurate subjective refraction. 2 The adoption of defocus curvebased clinical decisions, as also suggested by Rodriguez-Vallejo et al, is certainly a good way to avoid potential errors that may range from wrong spectacle prescription to unnecessary refractive surgery, both eventually leading to patient dissatisfaction. We also believe that subjective refraction should always be included by researchers in paper discussing refractive results with multifocal and EDOF IOLs.…”

mentioning

confidence: 96%

Reply: Automated and subjective refraction with monofocal, multifocal, and EDOF intraocular lenses: review

Bellucci,

Mora,

Tedesco

et al. 2023

J Cataract Refract Surg

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our study. 1 They underlined the very purposes of our review that are (1) the importance of considering automated refraction only as a starting point for subjective refraction, (2) the risk of inappropriate evaluation made by ophthalmologists who are unaware of the problem, (3) the risk of inappropriate spectacle or surgical treatment, and (4) the lack of information the surgeons are given about the optics of multifocal and EDOF IOLs. To make the ophthalmology community aware about the problem related to multifocal and EDOF IOLs and automated refraction was our main purpose, and the method suggested by Rodriguez-Vallejo et al. provides an excellent and reproducible way to obtain accurate subjective refraction. 2 The adoption of defocus curvebased clinical decisions, as also suggested by Rodriguez-Vallejo et al., is certainly a good way to avoid potential errors that may range from wrong spectacle prescription to unnecessary refractive surgery, both eventually leading to patient dissatisfaction. We also believe that subjective refraction should always be included by researchers in paper discussing refractive results with multifocal and EDOF IOLs. It may also improve IOL power selection for the second eye.Neural adaptation is an important key point that we did not discuss in our review. We agree on its importance for some patients, especially in multifocal pseudophakic eyes. Another issue is the value of wavefront refraction that is important although less familiar to ophthalmologists and would require a separate investigation and discussion.

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Refraction and defocus curves in eyes with monofocal and multifocal intraocular lenses

Cited by 7 publications

References 45 publications

Validation of a method to assess night myopia in a clinical setting

Validation of a method to assess night myopia in a clinical setting

Optical Performance of a Segmented Extended-Depth-of-Focus Intraocular Lens under the Influence of Different Values of Spherical Aberration Generated by Refractive Surgery

Reply: Automated and subjective refraction with monofocal, multifocal, and EDOF intraocular lenses: review

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