Selected Papers from “PRESBYOPIA 2022”

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 5133

Special Issue Editor


E-Mail Website1 Website2
Guest Editor
1. Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, ul. Mickiewicza 24 / 3B, 60-836 Poznan, Poland
2. Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
Interests: myopia; refractive errors; epidemiology of eye disorders; cataract and refractive disorders; retina disorders
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Special Issue Information

Dear Colleagues,

Presbyopia is a global problem, affecting over a billion people worldwide. As the world’s population ages, it has been predicted that 21% of the world’s population will be 60 years or older by 2050, and presbyopia may become one of the most pressing visual concerns of the 21st century, with its global prevalence predicted to increase to 1.8 billion individuals by 2050. One of the most widely accepted theories of the accommodation mechanism was described by Helmholtz: in response to ciliary muscle contractions, the crystalline lens thickness increases, the lens diameter decreases and both the anterior and posterior curvature of the lens increase, resulting in an increase in lenticular power and, therefore, accommodation. A contrasting theory proposed by Schachar suggests that ciliary muscle contractions lead to a selective increase in equatorial zonular tension, with the lens equator moving toward the sclera and the equatorial diameter of the lens increasing. Contact lenses, eye glasses, refractive surgery and intraocular lens surgery are the main modalities in presbyopia treatment, although they all have some disadvantages. There have also been several recent studies on the use of pharmacological agents for the management of presbyopia, thus, presenting as being a certainly very important and innovative field with an increasing number of effective and safe approaches.

Prof. Dr. Andrzej Grzybowski
Guest Editor

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Keywords

  • presbyopia
  • management of presbyopia
  • refractive surgery
  • anti-presbyopic surgery
  • multifocal IOLs
  • multi-focal contact lenses
  • progressive ocular lenses
  • pharmacologic treatment of presbyopia

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Published Papers (4 papers)

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Research

15 pages, 1315 KiB  
Article
Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia
by Maksymilian Onyszkiewicz, Julian Hilmers, Robert Rejdak, Eberhart Zrenner and Torsten Straßer
J. Clin. Med. 2024, 13(5), 1209; https://doi.org/10.3390/jcm13051209 - 21 Feb 2024
Viewed by 538
Abstract
Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye’s ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal [...] Read more.
Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye’s ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear. Full article
(This article belongs to the Special Issue Selected Papers from “PRESBYOPIA 2022”)
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11 pages, 2709 KiB  
Article
Optical Performance of a Segmented Extended-Depth-of-Focus Intraocular Lens under the Influence of Different Values of Spherical Aberration Generated by Refractive Surgery
by Luís Salvá, Scott García, Salvador García-Delpech, Anabel Martínez-Espert and Vicente Ferrando
J. Clin. Med. 2023, 12(14), 4758; https://doi.org/10.3390/jcm12144758 - 18 Jul 2023
Viewed by 744
Abstract
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. [...] Read more.
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. Full article
(This article belongs to the Special Issue Selected Papers from “PRESBYOPIA 2022”)
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11 pages, 5119 KiB  
Article
Comparison of the Polychromatic Image Quality of Two Refractive-Segmented and Two Diffractive Multifocal Intraocular Lenses
by Luis Salvá, Scott García, Salvador García-Delpech, Anabel Martínez-Espert, Diego Montagud-Martínez and Vicente Ferrando
J. Clin. Med. 2023, 12(14), 4678; https://doi.org/10.3390/jcm12144678 - 14 Jul 2023
Cited by 1 | Viewed by 885
Abstract
Evaluating chromatic aberration for a multifocal intraocular lens (MIOL) in vitro is essential for studying its performance because it helps determine the most appropriate lens for each patient, enhancing surgical outcomes. While refractive MIOLs with angular power variation have shown positive clinical outcomes, [...] Read more.
Evaluating chromatic aberration for a multifocal intraocular lens (MIOL) in vitro is essential for studying its performance because it helps determine the most appropriate lens for each patient, enhancing surgical outcomes. While refractive MIOLs with angular power variation have shown positive clinical outcomes, studies of these MIOLs on optical benches primarily employed monochromatic green light, neglecting the impact of longitudinal chromatic aberration (LCA) on MIOL performance. To address this gap, we evaluated the through-focus modulation transfer function (TF-MTF) and the point spread function (PSF) of two refractive segmented extended depth of focus intraocular lenses (IOLs) (Femtis Comfort and Precizon Presbyopic), comparing the results with those obtained with two widely known diffractive multifocal intraocular lenses (AcrySof IQ ReSTOR and FineVision Pod F). Measurements of the TF-MTF were conducted using both monochromatic and polychromatic light in a customized optical bench. The refractive designs exhibited distinct haloes in the PSFs. When comparing the refractive and diffractive designs, opposite signs of LCA were observed at near foci. These findings emphasize the influence of the optical design of IOLs on their performance under polychromatic light, providing valuable information for vision care professionals when selecting the most suitable lens for each patient. Full article
(This article belongs to the Special Issue Selected Papers from “PRESBYOPIA 2022”)
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11 pages, 2149 KiB  
Article
Comparison of Five Presbyopia-Correcting Intraocular Lenses: Optical-Bench Assessment with Visual-Quality Simulation
by Grzegorz Łabuz, Weijia Yan, Isabella D. Baur, Ramin Khoramnia and Gerd U. Auffarth
J. Clin. Med. 2023, 12(7), 2523; https://doi.org/10.3390/jcm12072523 - 27 Mar 2023
Cited by 6 | Viewed by 2430
Abstract
Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients’ requirements aligned with the available technology. Five Trifocal IOLs [...] Read more.
Presbyopia correction through implantation of a trifocal intraocular lens (IOL) is a modality offered to both cataract and refractive-lens exchange patients. To maximize postoperative satisfaction, IOL selection needs to be made based on patients’ requirements aligned with the available technology. Five Trifocal IOLs were assessed in this study, and their differentiating features were identified: Triumf POD L GF, AT Lisa Tri, Tecnis Synergy, AcrySof IQ PanOptix, and Acriva Trinova Pro C. The optical quality was assessed using the modulation-transfer-function principle. Simulated defocus curves were derived from a non-linear formula. Far-focus simulated visual acuity (simVA) was 0.03 logMAR or better for all the studied IOLs, showing minimal differences. However, each IOL’s intermediate focus position differed across a range from 61 cm to 80 cm; and for the near focus, it was 36 cm to 44 cm. Triumf demonstrated improved intermediate point at the expense of the near focus resulting in a lower predicted near VA. PanOptix exhibited the shortest range of vision without a clear distinction between intermediate and near-point. The remaining lenses presented three foci of comparable optical quality and, thus, simVA performance. Each model, however, revealed a different aperture-change response. Trinova function improved at intermediate but was worse at near for larger pupils. The opposite was observed for AT Lisa. Synergy’s optical quality change was predominantly associated with lower pupil diameter. In conclusion, the trifocal IOLs can be differentiated according to their secondary-foci position, light-energy distribution, and pupil-size-related behavior. The observed differences may translate directly into a clinical effect showing that the trifocal IOLs vary in their ability to deliver optimal vision at different distances, with some providing improved intermediate while others favor reading distance. The knowledge gained through this objective testing can support IOL selection, postoperative patient counselling and increase the chance of spectacle independence after surgery. Full article
(This article belongs to the Special Issue Selected Papers from “PRESBYOPIA 2022”)
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