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12 pags., 10 figs., As a large variety of intraocular lens (IOL) designs is commercially available in a growing market, selecting the best IOL for each patient has become a crucial task for a positive surgical outcome. Information about the measured or estimated performance of commercial lenses, as the through-focus modulation transfer function (TF-MTF) at a given frequency and pupil diameter, is routinely published. SimVis Gekko, a see-through simultaneous vision simulator based on temporal multiplexing, allows patients to experience the real world through different multifocal corrections prior to surgery. Implementing the maximum number of commercially available IOL designs into the portfolio of SimVis Gekko simulations is needed to provide a complete experience for the patients. We developed a new method to visually simulate IOL designs using temporal multiplexing, based only on publicly available information (mainly scientific literature or regulatory information), using the TF-MTF at 15cpd as input data to estimate the temporal coefficients that provide the best approximation to the real lens design. We validated the method with synthetic phase maps of equal area segmented bifocal and trifocal multifocal corrections for three pupil diameters of 3mm, 3.75mm and 4.5mm and applied it to three commercially available IOLs (trifocal or extended-depth-of-focus lenses). Through-focus visual acuity (TF-VA) curves were measured in seven patients using the SimVis simulations in the SimVis Gekko and matched, on average, the throughfocus VA measurements in patients with implanted IOLs, reported in the scientific literature (on average logMAR RMS error=0.05, corresponding to less than 3 letters of visual acuity charts)., We acknowledge financial support from the European Research Council ERC-2011-AdC 294099 (SM) from the Spanish Government FIS2017-84753R (SM), ISCIII DTS16/00127 (CD) and from Madrid Regional Government Doctorado Industrial IND2017/BMD-7670 (XB) and IND2018/BMD-9809 (CL)

Artículo con 5 figuras, Adaptive optics (AO) visual simulators are excellent platforms for non-invasive simulation visual performance with new intraocular lens (IOL) designs, in combination with a subject own ocular aberrations and brain. We measured the through focus visual acuity in subjects through a new refractive IOL physically inserted in a cuvette and projected onto the eye's pupil, while aberrations were manipulated (corrected, or positive/negative spherical aberration added) using a deformable mirror (DM) in a custom-developed AO simulator. The IOL increased depth-of-focus (DOF) to 1.53 ± 0.21D, while maintaining high Visual Acuity (VA, -0.07 ± 0.05), averaged across subjects and conditions. Modifying the aberrations did not alter IOL performance on average., Physiol S.L.; Research to Prevent Blindness; National Eye Institute (NIH NIE P30EY 001319); Comunidad de Madrid (IND2018/BMD-9809); Agencia Estatal de Investigación (PID2020-115191RB-I00).

13 pags., 9 figs., Purpose: Adaptive Optics allows measurement and manipulation of the optical aberrations of the eye. We review two Adaptive Optics set-ups implemented at the Visual Optics and Biophotonics Laboratory, and present examples of their use in better understanding of the role of optical aberrations on visual perception, in normal and treated eyes. Recent findings: Two systems (AOI and AOII) are described that measure ocular aberrations with a Hartmann-Shack wavefront sensor, which operates in closed-loop with an electromagnetic deformable mirror, and visual stimuli are projected in a visual display for psychophysical measurements. AOI operates in infrared radiation (IR) light. AOII is provided with a supercontiniuum laser source (IR and visible wavelengths), additional elements for simulation (spatial light modulator, temporal multiplexing with optotunable lenses, phase plates, cuvette for intraocular lenses-IOLs), and a double-pass retinal camera. We review several studies undertaken with these AO systems, including the evaluation of the visual benefits of AO correction, vision with simulated multifocal IOLs (MIOLs), optical aberrations in pseudophakic eyes, chromatic aberrations and their visual impact, and neural adaptation to ocular aberrations. Summary: Monochromatic and chromatic aberrations have been measured in normal and treated eyes. AO systems have allowed understanding the visual benefit of correcting aberrations in normal eyes and the adaptation of the visual system to the eye's native aberrations. Ocular corrections such as intraocular and contact lenses modify the wave aberrations. AO systems allow simulating vision with these corrections before they are implanted/fitted in the eye, or even before they are manufactured, revealing great potential for industry and the clinical practice. This review paper is part of a special issue of Ophthalmic & Physiological Optics on women in visual optics, and is co-authored by all women scientists of the research team., This study has been supported by European Research Council Grant Agreement ERC‐2011‐AdG‐294099 and EUROHORCS EURYI‐05‐102‐ES to SM; Spanish Government grants FIS2005‐04382, FIS2008‐02065, FIS2011‐25637, FIS2014‐240920, FIS2017‐84753 (SM); Spanish Government Human Resource Programs PTA2017‐13787‐I (MR) and FPU Fellowships (MV, SA, LS), Marie Curie Initial Training Networks PITN‐GA‐2010‐264605 Opal (AR) and H‐2020‐MSCA‐ITN‐2015‐ETN‐MyFUN 675137; Comunidad Autónoma de Madrid Fundacion Madri+d Industrial Doctorate Program (CL) and Technical Support Personnel (AMG). Collaborative agreements with PhysIOL (Liège, Belgium), Alcon Research Labs (Fort Worth, Texas, USA) and Essilor International (France) have partially funded some of the results presented here.

PURPOSE: To evaluate the impact of the lens aberrations on the adaptive optics visual simulation of pseudophakic intraocular lens (IOL) profiles. METHODS: In 20 right phakic eyes, lens higher order aberrations (HOAs) were calculated as the whole eye minus the corneal aberrations. Visual simulation using low and high contrast corrected distance visual acuity (CDVA) testing was carried out with the VAO instrument (Voptica, SL, Murcia, Spain), considering three optical conditions of the lens: removing HOA (no lens-HOA), removing spherical aberration (no lens-SA), and with lens HOA (natural condition). In addition, a through-focus visual simulation of a trifocal diffractive IOL profile with high contrast CDVA was also measured in two conditions: no lens-HOA and natural condition. Three different pupil sizes (3, 4.5, and 6 mm) were tested for all conditions. RESULTS: There were no significant intersubject differences between the three optical conditions and in the IOL simulation for all pupil sizes ( P > .05). For 4.5- and 6-mm pupils, mean VA values of the no-lens SA and no lens-HOA conditions were similar and slightly worse than those of the natural condition. Individual differences between the no lens-HOA condition and the other two optical conditions, estimated as 95% limits of agreement, were acceptable for 3-mm pupil but worse as pupil diameter increased. CONCLUSIONS: The effect of lens aberrations on visual simulation is imperceptible for a small pupil diameter of 3 mm. Although the increment of pupil size increases the probability of patients with significant visual impact of lens HOAs, the mean intersubject VA differences are negligible. [ J Refract Surg . 2019;35(2):126–131.]

15 pags., 9 figs., 1 tab., Visual simulators aim at evaluating vision with ophthalmic corrections prior to prescription or implantation of intraocular lenses (IOLs) in the patient’s eye. In the present study, we present the design, implementation, and validation of a new IOL-in-cuvette channel in an Adaptive Optics visual simulator, which provides an alternative channel for pre-operative simulation of vision with IOLs. The IOL is projected on the pupil’s plane of the subject by using a Rassow system. A second lens, the Rassow lens, compensates for an IOL of 20 D while other powers can be corrected with a Badal system within a 5 D range. The new channel was evaluated by through-focus (TF) optical quality in an artificial eye on bench, and by TF visual acuity in patients, with various IOL designs (monofocal, diffractive trifocal, and refractive extended depth of focus)., Funding. Spanish Government (FIS2017-84753R)