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This article belongs to the Special Issue Optical Imaging in Biomedical Engineering. Submission received: 6 May 2024 / Revised: 20 June 2024 / Accepted: 25 June 2024 / Published: 26 June 2024, This study compares a standard monofocal intraocular lens (IOL) with two rotationally asymmetric refractive multifocal IOLs, analyzing power profiles and wavefront data across three nominal powers. Tested IOLs included monofocal Acunex AN6 and multifocal AN6V (addition +1.50 D) and AN6VM (addition +3.00 D) by Teleon Surgical, at powers +10.00 D, +20.00 D, and +30.00 D. Using NIMO TR1504, power profiles, spherical aberration, and coma were analyzed. Multifocal lenses displayed an asymmetrical design, with zones for far and near vision and a central notch for far power. The multifocal AN6V and AN6VM showed neutral spherical aberration in the center, increasing to positive values, and finally achieving negative values towards the periphery. The vertical coma coefficient [Z(3:−1)] remains almost stable for the monofocal IOLs. The lower-addition multifocal IOLs induce primary vertical coma of +0.11 microns at 3 mm away from the lens center compared to +0.21 microns obtained with the high-addition lens. We can conclude that the multifocal AN6V and AN6VM lenses display an asymmetrical design. The final addition provided by these lenses depends on its nominal power. The variation of SA with optic size is more pronounced for the monofocal model, and it is dependent on the nominal power., Agencia Española de Investigación, Depto. de Optometría y Visión, Sección Deptal. de Óptica (Óptica), Fac. de Óptica y Optometría, TRUE, pub, Descuento UCM

Submitted: July 31, 2023 | Final revision submitted: February 1, 2024 | Accepted: February 5, 2024, Purpose: To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction. Setting: San Carlos Hospital, Madrid, Spain. Design: Prospective, monocentric, non-comparative study. Methods: Adults 21 years or older suitable for cataract surgery and with corneal astigmatism < 1.50D were bilaterally implanted with the RayOne EMV IOL and followed up for 3-months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire. Results: 50 eyes of 25 patients were included. At Month-3, the mean manifest spherical equivalent was -0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤ 0.0 logMAR and 95% ≤ 0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤ 0.2 logMAR. Mean monocular CDVA was -0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤ 0.2 logMAR over a 2 D range from +1.00 D to -1.25 D. Satisfaction was good in 96% of patients. Conclusion: Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction., Depto. de Optometría y Visión, Depto. de Inmunología, Oftalmología y ORL, Fac. de Óptica y Optometría, Fac. de Medicina, TRUE, pub, Pagado por el autor

Received 08 June 2023; Revised 12 October 2023; Accepted 23 October 2023; Published 11 November 2023; Issue Date April 2024. This study was funded by the Spanish Agencia Estatal de Investigación (grant number PID2020-114582RB-I00/AEI/10.13039/501100011033)., Purpose: To evaluate the impact of residual astigmatism on the optical and visual performance of an enhanced-monofocal isofocal intraocular lens (EM Isopure, BVI medical, Belgium) compared to a monofocal one (Micropure, BVI medical, Belgium). Methods: Laboratory investigation and prospective, comparative and randomized clinical study. Optical quality was assessed on an optical bench for 2.0, 3.0, and 4.5 mm pupils. The effect of residual astigmatism was investigated from through-focus images recorded with increasing amounts of regular positive astigmatism induced with a deformable mirror. To evaluate the impact of residual astigmatism, 28 eyes of 28 patients were randomly assigned to either group. Residual astigmatism was induced with positive and negative cylinder lenses at 90 and 180°. Visual acuity (VA) was measured at each step. Results: The optical performance of both IOLs was quite similar for 2.0 and 3.0 mm pupils. For 4.5-mm pupil, the EM Isopure showed a significant reduction of its optical quality in comparison with the monofocal IOL. When visual performance was evaluated, no statistically significant differences were found for any power of induced astigmatism. More differences were found when positive induced astigmatism was compared within each group, and VA was better when the astigmatism was induced at 180° vs. 90°. The greatest differences were found for and induced positive astigmatism of + 1.50D (p = 0.009 for Isopure and p = 0.023 for Micropure). Conclusions: The tolerance to residual astigmatism of the EM Isopure lens is similar to that of a reference monofocal lens with pupils up to 3.5 mm., Ministerio de Ciencia e Innovación (España), Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub, Pagado por el autor

Version of Record online: 13 February 2024; Manuscript accepted: 30 January 2024; Manuscript revised: 29 January 2024; Manuscript received: 05 September 2023., Purpose: To evaluate the optical and aberrometric outcomes of an enhanced monofocal intraocular lens (ISOPure) compared with those of a standard monofocal lens (MicroPure) having the same platform and material. Methods: A prospective, comparative and randomised clinical study. A total of 28 eyes of 28 patients were randomly assigned to either group. Monocular visual acuity (VA) was measured at distance and intermediate under photopic and mesopic conditions. Aberrometry was analysed for 3.0-, 4.0-, 4.5- and 5.0 mm pupils. The contrast sensitivity defocus curve was measured for 3.0- and 4.5-mm pupils, while the modulation transfer function (MTF) and Strehl ratio (SR) were assessed with a double-pass system. All measurements were performed monocularly 3 months after surgery. Results: No significant differences were found for distance VA. Under photopic conditions, intermediate VA was better with the ISOPure lens, while no significant differences were found between the lenses under mesopic conditions. Internal and total aberrations were higher for the ISOPure lens. No significant differences were found for corneal aberrations. Additionally, both the contrast sensitivity defocus curve and optical quality showed similar behaviour for each lens, with the MTF cut-off frequency exceeding 30 c/deg in both cases. Conclusion: The isofocal ISOPure lens enhanced intermediate VA without affecting distance VA under photopic conditions. Moreover, there were no significant differences in visual quality between the ISOPure and MicroPure lenses, despite the former exhibiting higher internal and total aberrations than the monofocal model., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Version of Record online: 15 March 2023; Manuscript accepted: 01 March 2023; Manuscript revised: 17 February 2023; Manuscript received: 20 October 2022, Introduction: To evaluate the backscattered light, objective scatter index (OSI) and retinal straylight in patients with moderate keratoconus and healthy control subjects. Methods: A prospective observational study was developed with 33 patients in the moderate-keratoconus group (KC) and 34 in the non-keratoconus group (NKC). Corneal densitometry was obtained using Scheimpflug corneal tomography and measurements were expressed in grayscale units (GSU) over four zones within a 12.00 mm diameter around the corneal apex. A straylight meter was used to determine the amount of intraocular straylight under scotopic conditions, and the straylight parameter (LOG(s)) and test duration were recorded. The Optical Quality Analysis System based on the double-pass technique determined the OSI value. Results: Significant differences were observed between the KC and NKC groups for corneal densitometry (except in the 6–10 mm zone), OSI and retinal straylight. A moderate and significant correlation was found between OSI and retinal straylight LOG(s) (r = 0.52, p = 0.002). Weaker and non-significant correlations were found between corneal densitometry and the other parameters analysed (i.e., OSI, retinal straylight LOG(s) and retinal straylight times). Conclusions: Backscattered light, retinal straylight and the OSI show clear differences between healthy eyes and those with moderate KC. The changes present in the stages of KC evaluated in the current study (stages II and III according to the Amsler–Krumeich classification) might alter the scattering of the light entering the eye., Universidad Complutense de Madrid (España), Banco Santander (España), Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To evaluate and compare the objective refractions obtained by autorefraction and aberrometry under different lighting conditions with an isofocal intraocular lens (Isopure, BVI medical, Liége, Belgium) compared to a monofocal control lens (Micropure, BVI medical, Liége, Belgium) with the same platform and material. Methods: Prospective, comparative and randomized study on patients undergoing cataract surgery and bilateral isofocal or monofocal IOL implantation. A total of 44 subjects were randomly assigned to either the isofocal group (n = 22) or the Micropure (n = 22). Manifest refraction (MR) was always performed under the same lighting conditions for all the patients. For objective refraction the autorefractor KR8800 and the aberrometer OPD-Scan III (Nidek Inc., Tokyo, Japan.) were used. For each eye included in the study, six result sets were collected: MR, AR (autorefraction measured with the autorefractor), WF-P and WF-M (Zernike-coefficients-based objective refraction, photopic and mesopic pupil size), OPD-C and OPD-M (autorefraction measured with the aberrometer in photopic and mesopic conditions). Results The mean sphere for MR was 0.03 ± 0.32D for the Isopure group and 0.24 ± 0.22D for the monofocal group (p = 0.013). For the Isopure group, Friedman analysis showed statistically significant differences for sphere measured with WF-P (p = 0.035), WF-M (p = 0.018) and OPD-M (p = 0.000), and SE measured with OPD-M (p = 0.004). In the Micropure lens group, the Friedman analysis showed differences for all values studied (p < 0.05). Correlation coefficients showed that AR is the objective method with the strongest correlation values for all components of refraction for both groups. Conclusion: The modification of the surfaces of the isofocal lens does not have a negative impact on the refraction obtained by AR compared to a standard monofocal intraocular lens., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose To compare measurements taken using a swept-source optical coherence tomography-based optical biometer (IOLmaster 700) and an optical low-coherence reflectometry biometer (Lenstar 900), and to determine the clinical impacts of differences in their measurements on intraocular lens (IOL) power predictions. Methods Eighty eyes of 80 patients scheduled to undergo cataract surgery were examined with both biometers. The measurements made using each device were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW), and pupil diameter (PD). Holladay 2 and SRK/T formulas were used to calculate IOL power. Differences in measurement between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results Mean patient age was 76.3±6.8 years (range 59-89). Using the Lenstar, AL and PD could not be measured in 12.5 and 5.25% of eyes, respectively, while IOLMaster 700 took all measurements in all eyes. The variables CCT, AQD, LT, and MK varied significantly between the two biometers. According to ICCs, correlation between measurements made with both devices was excellent except for WTW and PD. Using the SRK/T formula, IOL power prediction based on the data from the two devices were statistically different, but differences were not clinically significant. Conclusions No clinically relevant differences were detected between the biometers in terms of their measurements and IOL power predictions. Using the IOLMaster 700, it was easier to obtain biometric measurements in eyes with less transparent ocular media or longer AL., Unidad Docente de Inmunología, Oftalmología y ORL, Fac. de Óptica y Optometría, TRUE, pub

Deflectometry is an optical technique for determining properties such as power distribution, wavefront, etc., and measurement of the optical properties of an intraocular lens can provide relevant information for clinicians. The aim of the current study was to establish a protocol for measuring lens power maps and profiles of various optical designs of intraocular lenses with a deflectometer based on the phase-shifting Schlieren principle (NIMO TR1504, Lambda-X, Nivelles, Belgium). The results are discussed with respect to accuracy and repeatability, the influence of the use of filters, and whether to consider the intraocular lens as a thin or thick lens., Agencia Estatal de Investigación (España), Depto. de Óptica, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

The optical quality of a set of IOLs (modeling set: one monofocal and two bifocals) was assessed through focus by the area under the modulation transfer function (MTFa) metric and related to the visual acuity (VA) defocus curves of pseudophakic patients implanted with said IOLs. A non-linear relationship between the MTFa and clinical VA was obtained with an asymptotic limit found to be the best VA achievable by the patients. Two mathematical fitting functions between clinical VA and MTFa were derived with high correlation coefficients (R2≥0.85). They were applied to the MTFa obtained from a different set of IOLs with advanced designs (trial set: one extended range of vision -ERV-, one trifocal ERV and one trifocal apodized) to predict VA versus defocus of patients implanted with these IOLs. Differences between the calculated VA and the clinical VA for both fitting models were within the standard deviation of the clinical measurements in the range of -3.00 D to 0.00 D defocus, thus proving the suitability of the MTFa metric to predict clinical VA performance of new IOL designs., Ministerio de Economía y Competitividad de España, Fondos FEDER, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

The aim of this work was to compare an enhanced monofocal (RayOne EMV RAO200E, Rayner) and standard monofocal (RayOne RAO600C Aspheric, Rayner) intraocular lenses (IOLs) for three nominal powers (+10.00 D, +20.00 D and +30.00 D) as a function of the optical aperture diameter (pupil diameter) using a commercial Schlieren phase-shifting deflectometer NIMO TR1504 (Lambda-X, Belgium). From the wavefront maps measured by this instrument, the radial power profiles, the spherical aberration coefficients of the Zernike polynomial expansion (as a function of the optical aperture radius), and the root-mean-square (RMS) of the high-order aberrations (HOAs) were obtained and analyzed by comparing the two models. The results showed that the effective added power that could be obtained with the enhanced model depended directly on the pupil size and the power of the IOL implanted. The higher additions were achieved with the higher nominal IOL powers. The relationship between the pupil diameter, the corneal aberration of the patients and the power profile of these IOLs could have a crucial implication on the far distance and the final effective addition. However, it is important to note that these findings should be clinically validated through the implantation of these models in patients’ lenses., Agencia Estatal de Investigación (ESpaña), Depto. de Optometría y Visión, Depto. de Óptica, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To evaluate the early clinical outcomes of a new diffractive extended depth-of-focus (EDOF) intraocular lens (IOL). Methods: Prospective case series enrolling patients undergoing cataract surgery with implantation of the EDOF IOL AT LARA (Carl Zeiss Meditec, Jena, Germany). Distance, intermediate and near visual acuity were evaluated during a follow-up of 1 month. Likewise, defocus curve, binocular mesopic contrast sensitivity, perception of photic phenomena, patient satisfaction and spectacle independence were assessed. Results: The study enrolled 38 eyes of 19 patients with a mean age of 69.5 years. A significant reduction of manifest refraction and improvement in corrected distance visual acuity (CDVA) was observed with surgery (p < 0.001). All eyes achieved a 1-month postoperative binocular CDVA of 20/20 or better. Likewise, all eyes achieved a DCIVA of 20/30 or better at 1 month postoperatively, and a total of 92.1% achieved DCNVA of 20/40 or better. Concerning refractive predictability, 97.4% of eyes had a 1-month postoperative spherical equivalent within ±0.50 D. The level of patient satisfaction with distance, intermediate and near vision was high, with 95% of patients reporting that they would have the same surgical procedure with the same IOL again. Difficulties in night driving or associated to halos were low. A total of 89% of patients reported to be spectacle independent postoperatively. Conclusions: The EDOF IOL AT LARA is able to provide a functional restoration of the visual function across distances after cataract surgery, with very high levels of patient satisfaction and minimal incidence of photic phenomena., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Received: June 13, 2015 Accepted: February 04, 2016, PURPOSE: To compare visual outcomes, rotational stability, and centration in a randomized controlled trial in patients undergoing cataract surgery who were bilaterally implanted with two different trifocal intraocular lenses (IOLs) with a similar optical zone but different haptic shape. METHODS: Twenty-one patients (42 eyes) with cataract and less than 1.50 D of corneal astigmatism underwent implantation of one FineVision/MicoF IOL in one eye and one POD FineVision IOL in the contralateral eye (PhysIOL, Liège, Belgium) at IOA Madrid Innova Ocular, Madrid, Spain. IOL allocation was random. Outcome measures, all evaluated 3 months postoperatively, included monocular and binocular uncorrected distance (UDVA), corrected distance (CDVA), distance-corrected intermediate (DCIVA), and near (DCNVA) visual acuity (at 80, 40, and 25 cm) under photopic conditions, refraction, IOL centration, haptic rotation, dysphotopsia, objective quality of vision and aberration quantification, patient satisfaction, and spectacle independence. RESULTS: Three months postoperatively, mean monocular UDVA, CDVA, DCIVA, and DCNVA (40 cm) under photopic conditions were 0.04 ± 0.07, 0.01 ± 0.04, 0.15 ± 0.11, and 0.16 ± 0.08 logMAR for the eyes implanted with the POD FineVision IOL and 0.03 ± 0.05, 0.01 ± 0.02, 0.17 ± 0.12, and 0.14 ± 0.08 logMAR for those receiving the FineVision/MicroF IOL. Moreover, the POD FineVision IOL showed similar centration (P > .05) and better rotational stability (P < .05) than the FineVision/MicroF IOL. Regarding halos, there was a minimal but statistically significant difference, obtaining better results with FineVision/MicroF. Full spectacle independence was reported by all patients. CONCLUSIONS: This study revealed similar visual outcomes for both trifocal IOLs under test (POD FineVision and FineVision/MicroF). However, the POD FineVision IOL showed better rotational stability, as afforded by its design., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Corrected proof. © 2014 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. Todos los derechos reservados., Caso clínico: Presentamos el caso de una paciente operada previamente de cirugía de glaucoma con dispositivo XEN® sin incidencias, que presenta una ampolla hipertrófica produciendo un ectropión mecánico secundario. Se describe la técnica «Dry Lake» consistente en drenaje de la ampolla, previo bloqueo viscoelástico del dispositivo XEN® vía ab-interno, y el sellado de la ampolla inferior con pegamento tisular. Discusión: En el manejo de este tipo de ampollas se han postulado tratamientos médicos, suturas compresoras e incluso la utilización de sangre autóloga. El uso del Tissucol®, ya descrito en la cirugía del glaucoma, puede ser útil en este tipo de casos de ampollas hipertróficas secundarias al dispositivo ab-interno XEN®., Case report: The case of a patient with previous uncomplicated XEN® drainage glaucoma surgery is described, who presented with hypertrophic bleb and mechanical ectropion. Treatment consisted of the «Dry Lake» procedure to drain the hypertrophic bleb following blockage with viscoelastic of the ab-interno stent and bleb sealing with a tissue adhesive. Discussion: Proposals for the management of this type of bleb include therapeutic strategies, sutures or even autologous blood. The use of Tissucol®, already described in glaucoma surgery, may be appropriate to treat this complication of XEN® placement., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Este documento es un postprint., PURPOSE: To evaluate rotational stability and its influ-ence on postoperative visual acuity of different monofocal and multifocal toric intraocular lenses (IOLs). METHODS: A prospective interventional study was designed. Ninety-one patients with a mean age of 71.65 ± 11.82 years were implanted with toric IOLs after phacoemulsification. Three monofocal toric IOLs (the Lentis LT [Oculentis, Berlin, Germany], enVista [Bausch & Lomb, Rochester, NY], and AcrySof IQ [Alcon Laboratories, Inc., Fort Worth, TX]) and one multifocal toric IOL (AcrySof IQ ReSTOR; Alcon Laboratories, Inc.) were implanted. Preoperative and postoperative images were taken to calculate the misalignment due to the marking method. To evaluate rotation in the different follow-up visits, another photograph was taken 1 hour and 1, 7 and 30 days postoperatively. Refraction, uncorrected distance visual acuity (UDVA), and corrected distance visual acuity were measured 30 days postoperatively. RESULTS: Postoperative UDVA was 0.1 logMAR or better in 64.6% of eyes implanted with monofocal IOLs and 46.4% of eyes implanted with multifocal IOLs. The enVista toric IOL showed the best UDVA compared to the other monofocal IOLs, with 81% of eyes with 0.1 logMAR or better. The mean misalignment in the total group studied was 0.07° ± 0.60°; 69.6% of monofocal IOLs and 67.9% of multifocal IOLs showed less than 5° of rotation. A correlation was found between postoperative UDVA and rotation in the monofocal and multifocal IOLs implanted (r = 0.439 [P < .011] and = 0.787 [P = .001], respectively). CONCLUSIONS: At 1 month postoperatively, UDVA was slightly more affected by IOL rotation in multifocal than monofocal toric IOLs. The marking method was also effective., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Received 11 July 2016, Accepted 2 September 2016, Available online 25 October 2016, Purpose: to determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). Procedures: eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results: mean patient age was 75.17 ± 7.54 years (range: 57–92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. Conclusions: the use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation., Propos Déterminer si la dilatation pupillaire modifie les mesures biométriques et le calcul de la puissance de l’implant intraoculaire obtenus avec un nouveau biomètre optique basé sur la tomographie par cohérence optique swept-source (IOLMaster 700© ; Carl Zeiss Meditec, Jena, Allemagne) Méthodes Nous avons évalué prospectivement 81 yeux de 81 patients prévus pour la chirurgie de la cataracte au moyen du biomètre IOLMaster 700©, avant et après dilatation pupillaire avec tropicamide 1 %. Les mesures réalisées ont été : longueur axiale (AL), épaisseur cornéenne centrale (CCT), profondeur de la chambre antérieure (épaisseur cornéenne exclue) (ACD), épaisseur cristallinienne (LT), kératométrie moyenne (MK), distance blanc à blanc (WTW) et diamètre pupillaire (PD). Les formules Holladay II et SRK/T ont été employées pour calculer la puissance de l’implant intraoculaire. Nous avons évalué la concordance entre les deux méthodes de mesure (sous dilatation pupillaire et sans) au moyen des coefficients de corrélation intraclasse (ICC) et des graphiques de Bland-Altman. Résultats La moyenne d’âge des patients était de 75,17 ± 7,54 ans (intervalle : 57–92). Parmi les variables mesurées, la CCT, l’ACD, la LT et la WTW montraient des variations significatives en fonction de la dilatation pupillaire. On a observé une excellente corrélation intra-observateur entre les mesures réalisées avant et après la dilatation pupillaire. Celle-ci ne modifiait pas la prédiction de la puissance moyenne de l’implant avec Holladay 2 et SKR/T. Conclusions L’emploi de tropicamide 1 % produit des différences significatives du point de vue statistique mais pas clinique sur certaines mesures réalisées avec IOLMaster 700©. Cependant, la mesure de la puissance moyenne de l’implant intraoculaire n’est pas affectée., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Purpose: The scientific community has established Javal’s rule as a model linking refractive (RA) and keratometric (KA) astigmatism since its appearance more than 100 years ago. The aim was to improve the accuracy of this relationship according to subject’s age by applying the power vector analysis. Posterior corneal curvature has also been studied. Methods: The IOLMaster 700 optical biometer was used to measure the corneal thickness and the radius of curvature of the anterior and posterior corneal surfaces. Refractive error was determined by a non-cycloplegic subjective refraction process with trial lenses. Linear regression analyses were applied using J 0 and J 45 power vector components. An evaluation was carried out according to the subject’s age resulting into eight regression relationships for each astigmatic vector component for each relationship. Results: A total of 2254 right eyes from 2254 healthy subjects were evaluated. A trend towards against-the-rule astigmatism (ATR) was found with aging, both for refractive astigmatism (RA) and keratometric astigmatism (KA), with 95.2% of subjects under 20 years old having with-the-rule (WTR) KA, and only 22.8% above 79 years old. The following regression equations were found between RA and KA: J0RA = 0.73 × J0KA − 0.18 (R = 0.78) and J45RA = 0.70 × J45KA + 0.04 (R = 0.69) and between RA and total corneal astigmatism (TCA): J0RA = 0.73 × J0TCA + 0.13 (R=0.78) and J45RA = 0.70 × J45TCA − 0.06 (R = 0.68) for the whole sample, but with sensible differences among age groups, both in the slope and in the intercept. Conclusion: Ignoring the age of the subject when using Javal’s rule could lead to an error in the final cylinder calculation that would increase in high astigmatisms. Applying this new power vector approach based on subject’s age could improve the accuracy of the astigmatism prediction., Ministerio de Universidades de España, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Purpose: To evaluate medium-term clinical outcomes with XEN® 45 or XEN® 63 Gel Stent (Allergan, Dublin, Ireland) for treatment of primary open angle glaucoma (POAG). Materials and Methods. Retrospective, descriptive, and observational study involving 40 patients implanted with a XEN® 45 Gel Stent and 34 implanted with a XEN® 63 Gel Stent who had undergone POAG surgery and had been followed up and controlled between 12 and 36 months. Results: IOP dropped from 18.02 ± 5.23 mmHg preop to 13.81 ± 1.88, 14.80 ± 2.23, and 14.62 ± 1.90 at 1, 2, and 3 years after surgery (p < 0.001) consecutively with XEN® 45 and from 19.00 ± 6.11 mmHg preop to 15.47 ± 2.45, 14.66 ± 2.45, and 15.46 ± 2.48 at 1, 2, and 3 years after surgery (p < 0.001) with XEN® 63. The number of drugs used by patients to treat their glaucoma decreased after undergoing surgery in both groups. Within the XEN® 45 group, mean changes at 1 year, 2 years, and 3 years amounted to 70%, 74.3%, and 37.5%, respectively, whereas within the XEN® 63 group, the mean reduction was 75%, 79.8%, and 71.9%. When comparing the outcomes for the two groups, the differences did not prove to be statistically significant. More than 90% of the procedures included in the study (using either gel-stent device) were completed without any noteworthy complications. Conclusion: POAG surgical procedures with either XEN® 45 or XEN® 63 Gel Stent implantation could be a safe and effective treatment approach., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

En abierto en la web del editor. Submitted 3/3/2015 ; Revised 6/2/2015 ; Accepted 6/9/2015., PURPOSE: To evaluate visual results with two multifocal diffractive lenses designed with the same platform but with different additions. SETTING: Grupo Innova Ocular clinics. METHODS: A total of 50 eyes from 50 patients were included. Group 1 (n = 25) was implanted with the TECNIS® 1 ZLB +3.25 and group 2 (n = 25) with the TECNIS® 1 ZKB +2.75. Patients were assessed at 24 hours, 1 week and 1 month postoperatively. At surgical discharge, corrected (CDVA) and uncorrected distance visual acuity (UCDVA), near visual acuity (VA) at 25, 40 and 80 cm, visual quality and the defocus curve were measured. RESULTS: Changes in sphere and spherical equivalent were statistically significant (p<0.01) in both groups at 1 week and 1 month compared to preoperative values. In group 1, UCDVA logMAR at 1 month was 0.06 ± 0.02. In group 2, UCDVA at 1 month was 0.03 ± 0.03. In near vision, the TECNIS® 1 ZLB group obtained a VA logMAR of 0.35 ± 0.02 at 25 cm, 0.13 ± 0.02 at 40 cm and 0.27 ± 0.02 at 80 cm, while in the TECNIS® 1 ZKB group, the values were 0.38 ± 0.03, 0.14 ± 0.03 and 0.23 ± 0.06, respectively. No statistically significant differences were found either when results for visual quality were compared. CONCLUSION: Both the TECNIS® 1 ZLB and TECNIS® 1 ZKB are excellent options for obtaining good distance and near vision, in addition to providing good intermediate vision, especially at distances such as those required for working with computers., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Received 16 January 2015, Revised 30 March 2015, Accepted 31 March 2015, Available online 17 December 2015, PURPOSE: To measure the longitudinal chromatic aberration invivo using psychophysical and wavefront-sensing methods in patients with bilateral implantation of monofocal intraocular lenses (IOLs) of similar aspheric design but different materials (hydrophobic Podeye and hydrophilic Poday). SETTING: Instituto de Optica, Consejo Superior de Investigaciones Cientificas, Madrid, Spain. DESIGN: Prospective observational study. METHODS: Measurements were performed with the use of psychophysical (480 to 700 nm) and wavefront-sensing (480 to 950 nm) methods using a custom-developed adaptive optics system. Chromatic difference-of-focus curves were obtained from best-focus data at each wavelength, and the longitudinal chromatic aberration was obtained from the slope of linear regressions to those curves. RESULTS: The longitudinal chromatic aberration from psychophysical measurements was 1.37 diopters (D) ± 0.08 (SD) (hydrophobic) and 1.21 ± 0.08 D (hydrophilic). From wavefront-sensing, the longitudinal chromatic aberration was 0.88 ± 0.07 D and 0.73 ± 0.09 D, respectively. At 480 to 950 nm, the longitudinal chromatic aberration was 1.27 ± 0.09 D (hydrophobic) and 1.02 ± 0.13 D (hydrophilic). The longitudinal chromatic aberration was consistently higher in eyes with the hydrophobic IOL than in eyes with the hydrophilic IOL (a difference of 0.16 D and 0.15 D, respectively). Similar to findings in young phakic eyes, the longitudinal chromatic aberration from the psychophysical method was consistently higher than from wavefront-sensing, by 0.48 D (35.41%) for the hydrophobic IOL and 0.48 D (39.43%) for the hydrophilic IOL. CONCLUSION: Longitudinal chromatic aberrations were smaller with hydrophilic IOLs than with hydrophobic IOLs of the same design., Ministerio de Ciencia e Innovación (MICINN), European Research Council (ERC), Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Copyright: 2011 Wörner et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, A review of the current data on the cell density of normal adult human endothelial cells was carried out in order to establish some common parameters appearing in the different considered populations. From the analysis of cell growth patterns, it is inferred that the cell aging rate is similar for each of the different considered populations. Also, the morphology, the cell distribution and the tendency to hexagonallity are studied. The results are consistent with the hypothesis that this phenomenon is analogous with cell behavior in other structures such as dry foams and grains in polycrystalline materials. Therefore, its driving force may be controlled by the surface tension and the mobility of the boundaries., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

While multifocal intraocular lenses (MIOLs) are increasingly implanted to correct for presbyopia, how one sees with a multifocal correction is hard to explain and imagine. The current study evaluates the quality of various visual simulating technologies by comparing vision with simulated MIOLs pre-operatively and the implanted MIOLs post-operatively in the same patients. Two simulation platforms were used: (1) a custom-developed adaptive optics (AO) system, with two visual simulator devices: a spatial light modulator (SLM) and an optotunable lens operating under temporal multiplexing (SimVis); and (2) a wearable, binocular, large field of view SimVis2Eyes clinical simulator (SimVis Gekko, 2Eyes Vision, Madrid, Spain). All devices were programmed to simulate a trifocal diffractive MIOL (POD F, FineVision, PhysIOL). Eight patients were measured pre-operatively simulating the trifocal lens and post-operatively with implantation of the same MIOL. Through-focus decimal visual acuity (TF VA) was measured (1) monocularly in monochromatic light using a four-alternative-forced-choice procedure in the AO system, and (2) binocularly using a clinical optotype in white light. Visual simulations pre-operatively predict well the TF VA performance found post-operatively in patients implanted with the real IOL. The average RMS difference between TF curves with the different visual simulators was 0.05 ± 0.01. The average RMS difference between the TF VA curves with the SimVis pre-operatively and the real MIOL post-operatively was 0.06 ± 0.01 in both platforms, and it was higher in cataract eyes (0.08 ± 0.01, on average across simulators) than in eyes with clear lens. In either group, the shape of the TF curves is similar across simulators and pre-and post-operatively. TF curves cross-correlated significantly between simulators (lag k = 0, rho = 0.889), as well as with results with the real MIOL implanted (lag k = 0, rho = 0.853). Visual simulations are useful programmable tools to pr, European Research Council, H2020 Marie Skłodowska-Curie Actions, Gobierno de España, PhysIOL Group (Bélgica), Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To test the performance of a new monofocal intraocular lens, intended to extend depth of focus (Tecnis Eyhance, ICB00; Johnson & Johnson Vision, Inc) (ICB-IOL), in comparison to a standard monofocal IOL (Tecnis 1-piece, ZCB00; Johnson & Johnson Vision, Inc) (ZCB-IOL) of the same platform and material. Methods: Assessment of the optical performance of the two IOLs was made in vitro using an optical test bench with a model eye. The spherical aberration, modulation transfer function (MTF), and area under the MTF (MTFa) were obtained for pupil sizes ranging from 2 to 5 mm. Through-focus MTFa curves between -3.00 and +1.00 diopters (D) were obtained with three pupil sizes (2, 3, and 4.5 mm). Halo formation was also assessed for both lenses. Results: The ICB-IOL had slightly worse optical quality at its best focus (ie, lower MTF scores at distance vision) and more negative spherical aberration than the ZCB-IOL for pupils ranging from 2 to 3 mm. The maximum of the through-focus MTFa curve of the ICB-IOL with a 2-mm pupil shifted to a myopic defocus of -0.50 D. For larger pupils (≥ 3.5 mm), there were no differences in spherical aberration, MTF scores, and halo energy between the two lenses. Conclusions: The new ICB-IOL is a modified monofocal lens with 0.50 D of additional power in its central 2-mm zone and more negative spherical aberration values, which induce a myopic shift of the maximum of optical quality and could improve intermediate vision. For pupils larger than 3.5 mm, there were no differences between IOLs. The new ICB-IOL design would produce photic phenomena comparable to a standard IOL., Ministerio de Economía y Competitividad de España, Fondos FEDER, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To assess the biomechanical stability of three different marketed intraocular lenses (IOLs) with different haptic designs (four-loop IOL [Micro F FineVision model] and double C-loop IOL [POD F and POD FT models], all manufactured by PhysIOL), in silico (computer simulation) and in vivo (in the context of lens surgery). Methods: An in silico simulation investigation was performed using finite element modeling (FEM) software to reproduce the compression test defined by the International Organization for Standardization and in vivo implantation in patients in the context of lens surgery was evaluated 1 day and 3 months postoperatively. IOL decentration and rotation were tested. In addition, the stress and strains were analyzed with the finite element method. Results: In the in silico evaluation, the compression force for the POD F IOL was slightly lower than for the POD FT IOL and Micro F IOL for all compression diameters. The axial displacement was maximum for the POD FT IOL and the tilt, rotation, and lateral decentration were substantially lower than the acceptable tolerance limits established in ISO 11979-2. In the in vivo evaluation, a total of 45 eyes from 45 patients were selected, 15 eyes for each IOL model under assessment. Statistically significant differences were found between the Micro F and POD F IOLs for lateral decentration in the x-direction (in absolute value) at 3 months postoperatively (P = .03). Conclusions: Although statistically significant differences have been found when comparing the displacement, tilt, and rotation between the different lenses, these differences cannot be considered clinically relevant, which would suggest that all three IOL models yield excellent stability in those terms. FEM appears to be a powerful tool for numerical studies of the biomechanical properties of IOLs. [J Refract Surg. 2020;36(9):617-624.], Ministerio de Economía y Competitividad de España, Fondos FEDER, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose: To demonstrate the influence of the surgeon's and the operating room (OR) technicians' experience upon the outcome of femtosecond laser-assisted cataract surgery (FLACS). Materials and methods: Our study included 250 eyes from 156 patients who had undergone either cataract surgery or clear-crystalline-lens extraction and where capsulorhexis and lens fragmentation had been performed using the CATALYS® Precision System femtosecond platform (Abbott Medical Optics Inc., Santa Ana, CA, USA). The patients were operated either by an experienced surgeon in the use of femtosecond laser or by an inexperienced surgeon in that field and two technicians. The quantitative outcome measures were: Suction loss rate, vacuum time, number of consumables used by the patient, and intraoperative complication rate. Results: Both for the experienced and the inexperienced surgeons, suction loss rates as well as vacuum time decreased progressively as time went by and more surgical procedures had been completed by that surgeon. For a given surgeon suction time decreased significantly, going from 137 to 99s, as the assisting technician gradually gained experience. The number of consumables used in each procedure by the experienced surgeon ranged from 1.10 (for the first 50 cases) to 1.02 from those initial cases onwards. Regarding intraoperative complications, they also decreased progressively as the number of procedures completed by the surgeon increased. Conclusions: The experience of each team member involved in such procedures-be it surgeons or technicians-have an impact, to a greater or lesser extent, upon the surgery's outcome, as quantified by the outcome variables of choice., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

In recent years, the design of intraocular lenses (IOLs) has experienced a great deal of development and there is now a wide variety of designs. At the moment, some of the most interesting designs that allow for the greatest degree of innovation and customisation are lenses that combine a refractive part with a diffractive part

Received: 26-Aug-2021; Revision: 07-Dec-2021; Accepted: 21-Jan-2022; Published: 28-Apr-2022, Purpose: To evaluate the agreement between the biometric measurements used to calculate the size of the implantable collamer lenses (ICL) with different technologies: swept-source optical coherence tomography, spectral domain optical coherence tomography, and Scheimpflug tomography. Methods: This retrospective observational study included subjects undergoing refractive surgery with posterior chamber phakic IOL implantation to correct their myopia. The anterior chamber depth (ACD) and the horizontal white to white (WTW) or the angle to angle (ATA) distance were measured with the following four devices: the IOLMaster 700 biometer (Carl Zeiss Meditec, Jena, Germany), based on swept-source optical coherence tomography; the Cirrus and Visante optical coherence tomographs (Carl Zeiss Meditec) based on low-coherence interferometry; and the Pentacam rotating Scheimpflug camera (Oculus, Wetzlar, Germany). Results: In the horizontal corneal diameter measurements, there were statistically significant differences between Pentacam–IOLMaster 700 pair (P < 0.001) and Pentacam–Visante pair (P < 0.001). WTW from CIRRUS showed the lowest correlation when paired with Pentacam and IOLMaster 700 (R2 = 0.452 and 0.385 for Visante and R2 = 0.494 and 0.426 for Cirrus). Regarding the linear correlation of the ACD measurements, all pairs of devices were statistically significant and all of them showed a very good correlation index. Conclusion: There is a good agreement between the different devices under evaluation for ACD measurements. As for WTW, the values measured with the different devices showed large discrepancies with low correlation levels, especially when comparing the tomographs with the other devices under evaluation., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

settingsOrder Article Reprints Open AccessArticle Changes in Accommodative and Binocular Function following Phakic Intraocular Lens for High and Low-to-Moderate Myopia by Esther López-Artero 1ORCID,Francisco Poyales 1,Nuria Garzón 1,2ORCID,Alicia Matamoros 1,Alba Sáez 1,Ying Zhou 3ORCID andMaría García-Montero 1,2,* 1 Miranza Group, C/Galileo 104, 28003 Madrid, Spain 2 Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain 3 OCULUS Iberia, S.L., Tres Cantos, 28760 Madrid, Spain * Author to whom correspondence should be addressed. Int. J. Environ. Res. Public Health 2022, 19(11), 6716; https://doi.org/10.3390/ijerph19116716 Received: 27 April 2022 / Revised: 27 May 2022 / Accepted: 28 May 2022 / Published: 31 May 2022 Download Versions Notes Abstract The aim was to evaluate accommodative and binocular function of phakic intraocular lens implantable collamer lens (ICL) in high and low-to-moderate myopia. Prospective comparative cohort study with 38 myopic patients who underwent ICL implantation were divided into two groups of 19 patients, each one based on the spherical equivalent (SE): high-power (SE ≤ −6 D) and low-to-moderate (SE > −6 D). The push-up amplitude of accommodation (AA), monocular accommodative facility (MAF), distance and near ocular deviation, near convergence amplitude, near point convergence (NPC), stereopsis, and accommodative convergence/accommodation (AC/A) ratio were assessed before surgery and 1 week and 1 month postoperatively. The mean residual refractive error at 1 month after surgery improved in both groups, 0.18 ± 0.34 D and 0.09 ± 0.26 D, respectively (p < 0.001). There was a significant decrease in AA in both groups between preoperatively and at 1-week (p = 0.001; p = 0.008, respectively) and 1-month follow-up (p = 0.001; p = 0.008). For the rest of the binocular measurements, no statistically significant postoperative changes were found in any group. This finding suggests, Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

This review has identified evidence about pseudomyopia as the result of an increase in ocular refractive power due to an overstimulation of the eye’s accommodative mechanism. It cannot be confused with the term “secondary myopia”, which includes transient myopic shifts caused by lenticular refractive index changes and myopia associated with systemic syndromes. The aim was to synthesize the literature on qualitative evidence about pseudomyopia in terms that clarify its pathophysiology, clinical presentation, assessment and diagnosis and treatment. A comprehensive literature search of PubMed and the Scopus database was carried out for articles published up to November 2021, without a data limit. This review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Following inclusion and exclusion criteria, a total of 54 studies were included in the qualitative synthesis. The terms pseudomyopia and accommodation spasm have been found in most of the studies reviewed. The review has warned that although there is agreement on the assessment and diagnosis of the condition, there is no consensus on its management, and the literature describes a range of treatment., Depto. de Inmunología, Oftalmología y ORL, Depto. de Optometría y Visión, Fac. de Medicina, Fac. de Óptica y Optometría, TRUE, pub

CRUE-CSIC (Acuerdos Transformativos 2021), Purpose: In the event that any ocular parameter involved in the calculation of intraocular lens power could not be properly measured in one eye, it is important to know whether clinically relevant differences between both eyes can be expected. The aim of this work is to evaluate the symmetry of interocular biometric parameters. Methods: This was a prospective, cross-sectional study involving 4090 subjects. Patients underwent consecutive swept-source optical biometry performed with an IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany). The biometric parameters that were evaluated were: axial length (AL), mean anterior curvature (Rm), anterior chamber depth (ACD), crystalline lens thickness (LT), central corneal thickness (CCT) and white-to-white (WTW). The Chang-Waring chord distance (CWC-D) and the Chang-Waring chord angle (CWC-A) were also evaluated. Results: There is an excellent correlation between both eyes for almost all the biometric parameters under study, with the exception of the CWC. Agreement for AL was better for eyes shorter than 24 mm. The linearity of the OD-vs-OS relationship can be correctly assumed for all parameters (Cusum test: p > 0.05 in all cases). Conclusion: There are no clinically significant interocular differences for the biometric parameters under study, although for all of them, except the LT, statistically significant differences did arise. In the case of AL, moderate differences can be expected in eyes larger than 24 mm., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Diffractive multifocal intraocular lenses (IOLs) modulate chromatic aberration and reduce it at certain distances due to interactions between the refractive and diffractive chromatic components. However, the extent to which computer modeling and on bench measurements of IOL chromatic aberration translate to chromatic aberration in patients implanted with these multifocal IOLs (MIOLs) is not yet fully understood. In this study, we compare the chromatic difference of focus and longitudinal chromatic aberrations in pseudophakic patients implanted with different IOL designs (monofocal and trifocal IOLs) and materials (hydrophobic and hydrophilic), and compared them with predictions from computer eye models and on bench measurements with the same IOLs. Patient data consisted of results from 63 pseudophakic eyes reported in four different studies and obtained psychophysically in the visual testing channel of a custom-developed polychromatic adaptive optics system. Computational predictions were obtained using ray tracing on computer eye models, and modulation transfer function (MTF) on bench measurements on physical eye models. We found that LCA (in vivo/simulated) for far vision was 1.37 ± 0.08 D/1.19 D for monofocal hydrophobic, 1.21 ± 0.08 D/0.88 D for monofocal hydrophilic, 0.99 ± 0.06 D/1.19 D for MIOL hydrophobic, and 0.82 ± 0.05 D/0.88 D for MIOL hydrophilic. For intermediate and near vision, LCA (in vivo/simulated) was 0.67 ± 0.10 D/0.75 D and 0.23 ± 0.08 D/0.19 D for MIOL hydrophobic and 0.27 ± 0.15 D/0.38 D and 0.15 ± 0.15 D/−0.13 D for MIOL hydrophilic, respectively. In conclusion, computational ray tracing and on bench measurements allowed for evaluating in vivo chromatic aberration with different materials and designs for multifocal diffractive intraocular lenses., Eurepean Research Council, Gobierno de España, PhyIOL (Liege, Belgium), National Eye Institute (NEI), Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

En los últimos años, las metodologías educativas se orientan hacia un mayor protagonismo del alumno, su papel como agente y su responsabilidad en el proceso de aprendizaje. Esto se puso especialmente de manifiesto en el sistema universitario español al producirse la incorporación del mismo al Espacio Europeo de Educación Superior (EEES). Las necesidades docentes para estas nuevas metodologías son diferentes a las de otras más tradicionales como la clase magistral, en la que el alumno tiene un papel pasivo como receptor de información. En el último curso, se ha sumado un factor añadido a la forma de impartir docencia, siendo este la necesidad de hacer partícipes de la clase no solo a alumnos que se encuentran en la misma aula que el profesor, sino también a otros conectados de manera online (enseñanza híbrida). La introducción de recursos y materiales físicos y digitales que permitan la adaptabilidad a situaciones y necesidades diversas y actuales es, por tanto, imprescindible, además de natural en nuestra sociedad. Para que estos cambios metodológicos puedan producirse con eficacia, deben ser acompañados de un cambio en el entorno de aprendizaje y sus recursos, ya que estos pueden ser un elemento limitante o favorecedor de la dinámica didáctica que se produce dentro del aula. La hiperaula presenta un espacio flexible que puede adaptarse a técnicas, métodos y metodologías múltiples, tanto tradicionales como recientes, así como unos recursos que permiten llevarlos a cabo.

Se diseña un estudio para estimar la potencia emetropizante de la lente intraocular, modificando por distometría y de forma retrospectiva la potencia real de la lente intraocular implantada. Se implementarán unos modelos regresivos no lineales, que utilicen como variable respuesta la potencia recalculada retrospectivamente y como predictores una serie de inputs biométricos.Se recopiló una muestra de 481 ojos intervenidos de cataratas por 4 cirujanos con distintos tipos de implantes intraoculares. Todos los ojos fueron medidos preoperatoriamente con IOL Master® 700 (Carl Zeiss Meditec AG, Jena, Alemania) y Pentacam® HR (Oculus Optikgeräte GmbH, Wetzlar, Alemania) para la curvatura posterior corneal. Se preparó y se analizó el dataset para la selección de las variables eliminando correlaciones que produjeran colinealidad. La muestra se aleatorizó y posteriormente se dividió en dos partes con una ratio 80/20: entrenamiento (training) y validación (test) respectivamente.Se implementaron en crudo modelos regresivos mediante técnicas de Machine Learning y se entrenaron con la partición training. Posteriormente se optimizaron e hiperparametrizaron para mejorar y potenciar la predictibilidad. Se utilizaron técnicas de mejora (stacking) para ensamblar los mejores modelos finales, obteniendo un modelo definitivo al que se llamó Karmona®..., A study is designed to estimate the refractive power of the intraocular lens, back-calculated the real power of the implanted intraocular lens retrospectively by distometry. Non-linear regression models will be implemented, using the retrospectively back-calculated power as the response variable and biometric inputs as predictors.A sample of 481 eyes undergoing uneventful cataract surgery by 4 surgeons with different types of intraocular implants was collected. All eyes were measured preoperatively with IOL Master® 700 (Carl Zeiss Meditec AG, Jena, Germany) and Pentacam® HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) for corneal posterior curvature. The dataset was prepared and analyzed for variable selection by eliminating correlations that produced collinearity. The sample was randomized and subsequently split into two parts with a ratio 80 - 20: training and test.The regression models were implemented in raw form using Machine Learning techniques and trained with the training partition. Subsequently, they were optimized and hyperparameterized to improve and enhance predictability. Stacking techniques were used to assemble the best final models, obtaining a final model called Karmona®...

Received: 19 July 2021 / Revised: 26 August 2021 / Accepted: 1 September 2021 / Published: 3 September 2021 (This article belongs to the Special Issue Novel Research on Optometry and Vision Sciences), To evaluate the prediction error (PE) obtained in Phacoemulsification (Phaco) or Femtosecond (Femto) surgeries without considering posterior corneal astigmatism correction (non-PCA) versus the correction based on Abulafia-Koch + Medicontur (AK) and Barrett calculators in toric intraocular lens (IOL) power calculation. 58 right eyes were retrospectively retrieved from our dattabase. Two groups formed by 28 and 30 eyes depending on the surgery type, Phaco or Femto respectively, were defined. Astigmatism PE were evaluated considering the approach used for calculation of the implanted IOL power (AK) versus the estimation of PEs in non-PCA and Barrett formula. A doubly-multivariate analysis was conducted to assess the differences between-surgery types, within-methods of calculation, and interaction. Mean centroid PE was significantly different between non-PCA, AK and Barrett approaches (p < 0.0005), and neither differences (p < 0.239) nor interaction (p = 0.672) between Phaco or Femto were found. Post-hoc univariate analysis showed a higher PE for the x-component of the non-PCA method versus AK (0.15 D, p < 0.0005) and non-PCA versus Barrett (0.18 D, p < 0.0005), though no differences were found between AK and Barrett (0.03 D, p = 0.93). Against-the-rule under-correction and with-the-rule overcorrection were found in both arms when PCA was not considered. Both calculators provide comparable clinical results., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Purpose: Compare subjective (Rx) and objective (ObjRx) refractions outcomes with two autorefractors models and an aberrometer in eyes implanted with a hydrophobic trifocal IOL (FineVision POD F GF, Physiol, Liége, Belgium) and a hydrophilic one (FineVision POD F, Physiol, Liége, Belgium). Methods: Prospective comparative cohort study, with 100 subjects randomly assigned to either the POD F group (n = 50) or the POD F-GF group (n = 50). Postoperative eye examinations at 1-month visit included seven result sets, one for each assessment method: Rx, AR (automated refraction measured with the autorefractor KR8800), WF-P (Zernike-coefficients-based objective refraction, photopic pupil size), WF-M (Zernike-coefficients-based objective refraction, mesopic pupil size), WF-4 (Zernike-coefficients-based objective refraction, 4 mm pupil), OPD-C (automated refraction measured with the aberrometer OPD in the central pupil/photopic conditions), and OPD-M (automated refraction measured with the aberrometer OPD under mesopic conditions). Results: Mean differences between ObjRx and Rx reached statistical significance for sphere and spherical equivalent (M) only with OPD-C in the POD F-GF group. All ObjRx methods showed significant differences with Rx in the POD F group, with some values differing by more than 0.50 D (-0.58 D in M for the WF-P). Bland Altman plots showed better agreement for the astigmatic components and for sphere and spherical equivalents in both IOL groups measured with AR and OPD-M. Conclusions: None of the objective methods of refraction evaluated in this study were as reliable as the subjective refraction, irrespective of the lens material, but POD F-GF ObjRx seems to differ less with Rx than POD F ObjRx values., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Received 2 May 2021; Accepted 22 November 2021, Purpose. To compare postcataract surgery visual and optical performance between two trifocal intraocular lenses (IOLs) with the same optical design: a hydrophobic acrylic glistening-free IOL and a hydrophilic acrylic IOL. Methods. Patients were bilaterally implanted with either the hydrophobic or the hydrophilic IOL. The data of the patients’ right eyes were evaluated. Visual quality assessments included refractive outcomes, monocular visual acuity (VA) at far, intermediate, and near distances, defocus curve, aberrations (spherical aberration (SA)), root mean square (RMS) of corneal, internal, and total higher-order aberrations (HOAs)), and tilt of IOL. Results. Fifty-one patients were included in the analysis: 26 patients implanted with the hydrophobic IOL and 25 patients implanted with the hydrophilic IOL. At 1 month, no statistically significant differences were found for monocular uncorrected and corrected VA at distance, distance-corrected VA at intermediate and near, defocus curve, manifest spherical equivalent, total SA, and RMS of the total, internal, and corneal HOA. The defocus curve of both groups showed a visual acuity of 0.3 logMAR or better in the intermediate range from 0.5 to −2.5 D of vergence level with no significant differences between the groups. Compared to the hydrophilic group, y-direction tilt was significantly higher in the hydrophobic group (p=0.027). The total tilt and x-axis tilt did not differ between the groups. Conclusion. Both IOLs demonstrated an excellent quality of vision and provided the patient with a wide range of vision., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Se diseña un estudio para estimar la potencia emetropizante de la lente intraocular, modificando por distometría y de forma retrospectiva la potencia real de la lente intraocular implantada. Se implementarán unos modelos regresivos no lineales, que utilicen como variable respuesta la potencia recalculada retrospectivamente y como predictores una serie de inputs biométricos.Se recopiló una muestra de 481 ojos intervenidos de cataratas por 4 cirujanos con distintos tipos de implantes intraoculares. Todos los ojos fueron medidos preoperatoriamente con IOL Master® 700 (Carl Zeiss Meditec AG, Jena, Alemania) y Pentacam® HR (Oculus Optikgeräte GmbH, Wetzlar, Alemania) para la curvatura posterior corneal. Se preparó y se analizó el dataset para la selección de las variables eliminando correlaciones que produjeran colinealidad. La muestra se aleatorizó y posteriormente se dividió en dos partes con una ratio 80/20: entrenamiento (training) y validación (test) respectivamente.Se implementaron en crudo modelos regresivos mediante técnicas de Machine Learning y se entrenaron con la partición training. Posteriormente se optimizaron e hiperparametrizaron para mejorar y potenciar la predictibilidad. Se utilizaron técnicas de mejora (stacking) para ensamblar los mejores modelos finales, obteniendo un modelo definitivo al que se llamó Karmona®...

Poner la última tecnología similar a la innovación en el sector de la Optometría para atención primaria a pacientes teniendo en cuanta la inserción laboral, inclusión y accesibilidad utilizando competencias digitales simples en interacción en la nube.

La presbicia, también conocida como vista cansada, es una pérdida de la amplitud de acomodación asociada a la edad. Se produce por el aumento del grosor y endurecimiento del cristalino, ya que está en continuo crecimiento. Es capaz de enfocar objetos a diferentes distancias gracias a su mecanismo de acomodación, que es la capacidad que tiene el cristalino de cambiar su forma y potencia para el enfoque de objetos lejanos y próximos. Con el tiempo pierde transparencia, flexibilidad y aumenta su rigidez, siendo una de las principales causas de la presbicia. Por ello es un problema que afecta a mil millones de personas en todo el mundo, causando problemas en la calidad de vida. La presbicia depende de la edad, pero también existen otros factores como la refracción del sujeto, costumbres, hábitos, distancia de trabajo, medios económicos, factores ambientales, etc. Tras muchos años de estudios, el mecanismo de la acomodación sigue siendo un tema de controversia. Han surgido diferentes teorías a lo largo de la historia, pero la mayoría están basados en la teoría de Helmholtz. Atendiendo a la literatura científica, existen diferentes técnicas de corrección recomendadas para la presbicia. Las lentes oftálmicas son el método principal para mejorar los síntomas. Dentro de las lentes oftálmicas distinguimos las lentes monofocales que aportan una graduación determinada para una sola distancia, las lentes bifocales que fueron las pioneras en la compensación de ametropías a varias distancias, siendo útiles solo en VL y VP y las lentes progresivas que aportan la visión intermedia además de la lejana y cercana. Las lentes de contacto son otro método de corrección. Proporcionan un amplio campo visual porque están más cerca del ojo y producen menos distorsiones que las lentes monofocales. Existen diferentes posibilidades para compensar la presbicia con lentes de contacto: LC para lejos con gafas para cerca, LC para cerca con gafas para lejos, monovisión en donde un ojo se corrige para

Objetivo: Evaluar si la agudeza visual en el momento del tratamiento (AV pretratamiento) puede ser un factor pronóstico del resultado obtenido tras el tratamiento en pacientes con Degeneración Macular Asociada a la Edad (DMAE) tratados con Eylea (Aflibercept). Material y métodos: Se realizó un estudio retrospectivo compuesto por 131 ojos de 116 pacientes con DMAE húmeda de la Clínica Oftalmológica Miranza IOA de Madrid donde todo ellos fueron tratados con Eylea (Aflibercept). Los pacientes se dividieron en tres grupos según la agudeza visual que tenían antes de iniciar el tratamiento y se estudió su evolución durante un año (grupo 1: pacientes con AV comprendidas entre 0 y 0.25 logMAR, grupo 2: pacientes con AV comprendidas entre 0.25 y 0.75 logMAR y grupo 3: pacientes con AV comprendidas entre 0.75 y 1.3 logMAR). También se analizó la influencia del número de inyecciones en la AV de los pacientes. Resultados: La edad media de los pacientes era de 76.44 ± 10.00 años. Se encontró que la AV media de los pacientes al finalizar el año del estudio es mejor que la AV media inicial, siendo esta diferencia estadísticamente significativa. En pacientes que partían de una peor AV (grupo 3) se observaron diferencias estadísticamente significativas (pvalor < 0.05) entre la AV inicial y la AV final, al igual que en el grupo 2. En el grupo 1 (pacientes con mejor AV inicial) no se observaron diferencias estadísticamente significativas (p-valor = 0.138) entre ambas agudezas visuales. Se observó que los pacientes con peor AV pretratamiento mejoraron más que los pacientes con mejor AV previa. La relación entre el número de inyecciones administradas a los pacientes y su AV previa al tratamiento fue estadísticamente significativa (p-valor < 0.05). Conclusiones: En general, los pacientes tratados con Eylea mejoran su AV tras un año de tratamiento, siendo los pacientes con peor AV inicial los que más mejoran, por lo que la AV puede utilizarse como factor pronóstico en el tratamiento de la, Purpose: To evaluate whether visual acuity at the time of treatment (pretreatment VA) can be a prognostic factor for the results obtained after treatment in patients with AgeRelated Macular Degeneration (AMD) treated with Eylea (Aflibercept). Material and method: A retrospective study was carried out consisting of 131 eyes of 116 patients with wet AMD at the Miranza IOA Ophthalmology Clinic in Madrid, where all of them were treated with Eylea (Aflibercept). The patients were divided into three groups according to the visual acuity before starting the treatment and their evolution was studied for one year (group 1: patients with VA between 0 and 0.25 logMAR, group 2: patients with VA between 0.25 and 0.75 logMAR and group 3: patients with VA between 0.75 and 1.3 logMAR). The influence of the number of injections in the VA of the patients was also analyzed. Results: The mean age of the patients was 76.44 ± 10.00 years. The mean VA of the patients at the end of the study year was found to be better than the initial mean VA, being this difference statistically significant. In patients starting from a worse VA (group 3) statistically significant differences (p-value < .05) were observed between both visual acuities. Patients with worse pretreatment VA were observed to improve more than patients with better previous VA. The relationship between the number of injections and the pretreatment VA was statistically significant (p-value < 0.05). Conclusions: Patients treated with Eylea improve their VA after one-year of treatment, with patients with worse initial VA improving the most, so VA can be used as a prognostic factor in the treatment of wet AMD with Eylea. The number of intravitreal injections of the drug does not influence the improvement or worsening of VA in patients.

Recibido: 11 enero 2020; Aceptado: 29 junio 2020, Purpose: To assess differences in a new objective metric obtained with a double-pass technique between a group with accommodation insufficiency (AI) and a control group and to explore the diagnostic capabilities of this new tool in comparison to conventional procedures. Methods: Retrospective cross-sectional case-control phase 1 study. Two groups age ranging from 8 to 18 years were recruitment: AI and control group. The diagnostic criterion of AI was based on monocular accommodative amplitude (AA) 2 D below Hofstetter’s calculation for minimum AA and monocular accommodative facility (MAF) failing with minus lens and cut-off at ≤ 6 cycles per minute. Accommodative response with a double pass device (HD Analyzer, Visiometrics) was measured, performing an evaluation from +1.00 D to −3.50D (−0.5D steps), offering the width of the profile at 50% (WP) in minutes of arc. Results: Differences were found between groups for the AA, MAF and MEM retinoscopy (p < 0.0001, p < 0.001, p = 0.037). The discriminative capacity of MEM retinoscopy for AI diagnosis was significant and the cut-off that maximized the sensitivity and specificity was > 0.5 D. Considering WP 50% in different points, the discriminative AI diagnosis capacities for the points of 2.0 D and 2.50 D were significant (ROC-AUC 0.78; p = 0.03 and p = 0.02). Conclusions: Double-pass system metric differed between patients with AI and control group, therefore the aim of a Phase I study was achieved. Further steps with higher sample sizes are required to evidence if the system really provides any advantage versus conventional methods in the diagnosis of AI., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Review/Update, The purpose was to review and document the methods used to calculate the power of the intraocular lens (IOL) to be implanted in cataract surgery in the specific scenario of eyes with keratoconus (KC). This review was conducted of all scientific articles published in English that focused on the parameters and formulas used to calculate the power of the IOL to be implanted in eyes with KC undergoing cataract surgery. There are few publications that show in detail how IOL power is calculated in those particular cases. If the keratometric value is used based on the standard refractive index (1.3375), this results in a postoperative refractive error with a tendency to hyperopia. The SRK/T formula is the formula yielding the best outcomes. The greater the severity of KC, the greater the deviation of the postoperative refractive status deviation from the target outcome., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, inpress

Received: 23 july 2020 This study was sponsored by PhysIOL SA, Liège, Belgium., Purpose: To compare clinical outcomes in a prospective trial of cataract surgery patients bilaterally implanted with two different trifocal intraocular lenses (IOLs) with very similar optical designs but consisting of different IOL materials (hydrophobic and hydrophilic). Patients and Methods: Fifty-one patients (102 eyes) were randomized to receive trifocal IOLs bilaterally – FineVision POD F (hydrophilic) or FineVision POD F GF (hydrophobic) (both PhysIOL, Liége, Belgium). The follow-up period was 3 months. Outcome measurements included uncorrected distance (UDVA), corrected distance (CDVA), distance-corrected intermediate (DCIVA), and distance-corrected near visual acuity (DCNVA), refraction, negative dysphotopsia, optical quality of vision, contrast sensitivity under photopic and mesopic conditions, halometry (discrimination index), and patient-reported outcomes. Results: At the final study visit, mean (SD) values for binocular UDVA, CDVA, DCIVA (80 cm), and DCNVA (40 cm) were − 0.01 (0.06), − 0.04 (0.04), 0.09 (0.10), and 0.10 (0.09) logMAR, respectively, for POD F, and 0.01 (0.08), − 0.03 (0.03), 0.08 (0.1), and 0.13 (0.11) respectively, for POD F GF. Defocus assessments showed a continuous curve with a functional range of visual acuity (≤ 0.15 logMAR) from ∼ 30 cm to infinity in both groups. The discrimination index was > 0.85 for all patients, and both groups showed similar contrast sensitivity under photopic and mesopic conditions. At 3 months, no patient reported negative dysphotopsia, and high satisfaction rates were observed. Conclusion: Clinical outcomes showed no significant difference between each lens when measured at 1 month and 3 months after implantation. This equally good clinical performance of hydrophilic and hydrophobic trifocal lenses allows the surgeon to choose the IOL material based on personal preferences or patients’ needs., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub

Submitted: November 19, 2019 | Final revision submitted: January 26, 2020 | Accepted: February 17, 2020, Purpose: To develop a new method that makes it easy to detect accuracy deficiencies of any intraocular lens power calculation formulae and to test it on 9 different formulae. Setting: IOA, Madrid, Spain Design: Retrospective observational case series. Methods: This study’s first stage included 3519 eyes from 3519 candidates to cataract surgery for which frequency distributions for the following biometric eye parameters were computed: axial length (AXL), anterior-chamber depth (ACD), lens thickness (LT), white-to-white (WTW) and mean corneal radius (Rm). The resulting data for each parameter were 5th, 25th, 75th and 95th percentile, which allowed us to define the corresponding normality range. In a second stage, the new graphic-representation method was tested for 9 different formulae in a sample of 70 eyes undergoing cataract surgery with multifocal intraocular lens (MIOL) implantation. Results: Normality ranges (defined as the 25th-to-75th-percentile interval) were 22.84 to 24.42 mm for AXL, 2.86 to 3.39 mm for ACD, 4.36 to 4.88 mm for LT, 11.64 to 12.19 mm for WTW and 7.52 to 7.87 mm for Rm, with lower sizes in women. No significant differences were found along the 9 formulae for percentage of eyes in ±0.50D (p=0.82) or ±1.00D (p=0.97). The new graphical method showed less accuracy in ±0.50 D for ACDs from 2.46 to 2.85 mm (5th to 25th percentile) for several formulae (p<0.05). Conclusions: 9 formulae showed non-significant differences in the general predictability for a sample of eyes candidates to MIOL implantation. Predictability in this sample decreased for short ACDs., Depto. de Optometría y Visión, Fac. de Óptica y Optometría, TRUE, pub