Search Results (46)

Multi-wavelength lensless microscopy enables high-speed, wide-field, and high-throughput imaging, making it highly attractive for modern biomedical applications. However, its practical performance is often limited by unreliable autofocusing and wavelength-dependent phase inconsistencies, which together degrade reconstruction fidelity in complex environments. To explicitly address these two limitations, we present a fully scanning-free computational microscopy framework using a static four-wavelength Light-Emitting Diode (LED) illumination module that sequentially switches between wavelengths to provide strong spectral constraints. For robust geometric parameter estimation, we develop an Adaptive-Weighted Multi-wavelength Autofocus (A-WMAF) scheme that exploits the differential defocus sensitivities of multiple wavelengths to yield a single, sharply peaked autofocus curve and thereby reliably determines the sample–sensor distance. To mitigate chromatic phase inconsistencies, we further introduce an iterative optical-path-difference (OPD)–domain adaptive fusion strategy that fuses multi-wavelength phase estimates in a physically consistent OPD space, suppressing wavelength-dependent artifacts and reconstruction noise. With only four raw holograms acquired within seconds, the proposed method achieves high-fidelity quantitative phase reconstruction with a Phase Structural Similarity Index Measure (SSIM) of 0.9942 and a quantitative OPD accuracy of 95.0%, as well as a measured lateral resolution of 1.23 µm, surpassing the Nyquist–Shannon sampling limit. Experimental demonstrations on fixed biological samples and long-term live-cell monitoring validate that the proposed framework simultaneously achieves reliable autofocusing and chromaticity-robust phase fusion, highlighting its potential for high-throughput biomedical imaging and clinical diagnostics. Full article

Background/Objectives: Enhanced monofocal and non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs) aim to improve intermediate vision while maintaining contrast sensitivity. However, direct comparative evidence under both photopic and mesopic conditions remains limited. This study prospectively compared the visual performance of two enhanced monofocal IOLs (Tecnis^® Eyhance^™ and ISOPure^®) and one non-diffractive EDoF IOL (AcrySof^® IQ Vivity^™). Methods: Sixty patients undergoing bilateral cataract surgery were implanted with one of three IOL groups (n = 20 each). Patients were assigned to one of three IOL groups based on preoperative consultation and clinical indications. One month postoperatively, monocular corrected distance (CDVA), distance-corrected intermediate (DCIVA), and near visual acuity (DCNVA) were measured under photopic and mesopic conditions. Photopic defocus curves, contrast sensitivity under photopic and mesopic conditions and correlation between pupil diameter and visual acuities were also assessed. Results: Baseline characteristics were comparable among groups. Under photopic conditions, Vivity^™ achieved significantly better UDVA, DCIVA and DCNVA than both Eyhance^™ and ISOPure^®. Under mesopic conditions, distance acuity did not differ significantly, but Vivity™ showed superior DCIVA and DCNVA. Defocus curves demonstrated a broader functional range of vision with Vivity™, while Eyhance^™ and ISOPure^® showed nearly overlapping profiles. Contrast sensitivity was similar among all IOLs under both lighting conditions, with no statistically significant differences. Conclusions: The non-diffractive EDoF AcrySof^® IQ Vivity^™ provided a wider and more functional depth-of-focus than the enhanced monofocal lenses evaluated, without compromising contrast sensitivity. Eyhance^™ and ISOPure^® offered comparable performance, with good distance vision and modest depth-of-focus extension. All three IOLs maintained CS levels comparable to those typically reported for standard monofocal IOLs under both photopic and mesopic illumination, indicating no clinically relevant contrast penalty. Full article

Background/Objectives: The purpose of the study is to assess visual and refractive outcomes and patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) in a monovision configuration. Methods: Prospective, monocentric, non-comparative study including adults 21 years or older, with astigmatism less than 1.50 D, who were suitable for bilateral cataract surgery targeted with −1.00 D monovision. Participants were implanted with the RayOne EMV and followed up for three months. Outcome measures included refraction, monocular and binocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuity (UIVA and DCIVA) at 66 cm and 80 cm, binocular defocus curve, and CatQuest-9SF questionnaire. Results: Sixty eyes of thirty patients were included. Postoperative spherical equivalent (SEQ) was −0.16 ± 0.29 D in the dominant eyes and −1.24 ± 0.43 D in the non-dominant eyes. Binocularly, mean UDVA at 4 m was −0.01 ± 0.07 and 0.1 logMAR or better in all patients. Mean binocular UIVA at 66 cm was 0.08 ± 0.08 and 0.2 logMAR or better in 92.9% of patients. Binocular UDVA was statistically significantly improved compared to monocular UDVA of the dominant eye targeted for distance (p < 0.001). Similarly, binocular UIVA was statistically significantly improved compared to monocular UIVA of the non-dominant eye targeted for −1.00 D (p < 0.001). A total of 96.6% of patients were satisfied with their sight. Conclusions: Bilateral implantation of an enhanced monofocal IOL in a monovision configuration provided excellent binocular uncorrected vision at distance and intermediate ranges, demonstrating effective binocular summation and a high level of patient satisfaction. Full article

Background/Objectives: To compare the clinical outcomes following cataract surgery with implantation of a new partial depth of field (DOFi) intraocular lens (IOL) versus a monofocal IOL of identical material, platform, and haptic design. Methods: Single-center, non-randomized trial including 55 patients randomly assigned to be implanted either with the partial-DOFi IOL Tecnis PureSee (partial-DOFi group, 29 patients) or the Tecnis monofocal IOL DCB00/ZCU (both Johnson & Johnson Surgical Vision) (monofocal group, 26 patients). Monocular visual acuity (VA), refractive, binocular defocus curve, and patient-reported outcomes (QoV and Catquest 9SF questionnaires) were evaluated during a 3-month follow-up. Results: No significant differences between monofocal and partial-DOFi groups were found in monocular postoperative uncorrected- (0.03 ± 0.08 vs. 0.05 ± 0.10, p = 0.419) and corrected-distance VA (−0.03 ± 0.04 vs. −0.03 ± 0.05, p = 0.642). Significantly better distance-corrected intermediate VA was found in the partial-DOFi group (0.29 ± 0.08 vs. 0.10 ± 0.06, p < 0.001). Similarly, postoperative monocular distance-corrected near VA was better in the partial-DOFi group (0.51 ± 0.10 vs. 0.31 ± 0.09, p < 0.001). In the defocus curve, significantly better distance-corrected VAs compared to monofocal were found for all defocus levels from −1.50 to −4.00 D. Minor reports of starbursts were found in both IOL groups. With the Catquest questionnaire, some significant differences were found between groups including reduced difficulty reading newspapers (p < 0.001), improved visibility of prices while shopping (p < 0.001) and enhanced performance of hobbies (p = 0.030) and needlework (p < 0.001). Conclusions: The partial-DOFi IOL evaluated demonstrates superior intermediate and near visual performance compared to a monofocal IOL, while maintaining equivalent distance vision and visual quality. Full article

Background/Objectives: To investigate visual acuity, refractive outcomes and the predictive accuracy of modern intraocular lens (IOL) power calculation formulas in eyes implanted with two presbyopia-correcting IOLs: trifocal Zeiss AT LISA TRI and the nondiffractive EDOF Teleon Comfort. Methods: This retrospective consecutive chart review included 115 patients who underwent uncomplicated bilateral cataract surgery and received either the LISA TRI (n = 56) or Comfort (n = 59). Biometric measurements were obtained preoperatively, and refractive outcomes were assessed 1, 3, and 6 months postoperatively. Postoperative spherical equivalent (SEQ) was compared to predicted SEQ using the ESCRS calculator and IOLCON platform. Outcome measures included mean prediction error and mean absolute error (MAE). Distance-corrected visual acuity (VA), uncorrected VA, defocus curves, preferred viewing distances, contrast sensitivity, and photopic reading speed were also analyzed. Results: All formulas performed better in the LISA TRI group, with significantly lower MAE and higher proportions of eyes within ±0.50 diopters (D). Systematic prediction error offsets were observed for three formulas (K6, Castrop, Hoffer QST) in the LISA TRI group and for all five formulas in the MF15 group. Refractive stability was achieved by 3 months for the LISA TRI, while 20% of Comfort eyes continued to show SEQ shifts > 0.50 D at 3 months. Defocus equivalent (DEQ) had lower proportions of eyes within ±0.50 D than SEQ. Conclusions: The LISA TRI demonstrated superior predictive accuracy, faster refractive stabilization, and stronger near performance than the Comfort. These findings support the importance of IOL-specific constant optimization and highlight the need for incorporating DEQ into routine refractive outcome evaluation. Full article

Background/Objectives: This study aimed to evaluate the one-year real-world effectiveness of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in controlling myopia progression in a Turkish pediatric cohort and to identify predictors of treatment response using age-specific physiological growth curves. Methods: This retrospective single-center study included 54 patients (108 eyes) aged 6–16 years with myopia who wore DIMS spectacle lenses full time for 12 months. The primary outcomes were spherical equivalent refraction (SER) success and axial length (AL)-based treatment response. Treatment success was defined as an SER progression of ≤0.50 dioptres per year and AL elongation within age-specific physiological limits. Subgroup analyses were performed according to age, gender, and the baseline AL group. Results: After 12 months, the mean AL elongation was 0.14 ± 0.31 mm, and the mean SER change was −0.28 ± 0.42 D. SER-based success was achieved in 85.2% of eyes. For AL-based response, 61.1% of eyes showed a good response, 16.7% showed a low–moderate response, and 22.2% had no response. Eyes with moderate baseline AL exhibited significantly less axial elongation than those with high baseline AL (p = 0.001). Children aged ≥ 10 years demonstrated better AL-based responses (p = 0.016). The baseline AL group significantly predicted the AL treatment response, while both the baseline AL group and gender predicted SER success. Gender was associated with SER outcomes but not with AL-based response. Conclusions: DIMS spectacle lenses effectively reduced myopia progression and axial elongation in this real-world Turkish pediatric cohort. Baseline AL and gender were significant predictors of treatment outcomes. Incorporating age-specific physiological growth curves provided an individualized framework for interpreting treatment success. Further prospective studies with larger samples and longer follow-up are warranted to confirm these findings. Full article

Background: To assess the agreement among prediction models for the functional classification of intraocular lenses (IOLs) and discuss their limitations in evaluating pupil dependency of a sinusoidal IOL. Methods: An ISO-compliant optical bench setup with modifications to characterize the modulation transfer function area (MTFa) across pupil diameters from 1.5 to 5.5 mm was used to measure the Acriva Trinova Pro C Pupil Adaptive IOL. Six prediction models (Vega et al., 2018, Fernández et al., 2019, Alarcón et al., 2016, Armengol et al., 2020 were applied to estimate visual acuity defocus curves from MTFa and functional classification based on the depth-of-field (DOFi) and the increase in visual acuity (ΔVA) from intermediate to near. Results: Defocus curves for all prediction models consistently demonstrated a Full-DOFi response (>2.3 D at 0.2 logMAR), with differences in ΔVA emerging across pupil diameters. Continuous decreases (ΔVA < 0.05 logMAR) were observed at pupil diameters <2.5 mm, while Smooth transitions (ΔVA from 0.05 to 0.14 logMAR) occurred between 2.5–3.0 mm for all models except for Vega. At pupil diameters >3.5 mm, most models transitioned to a Steep classification (ΔVA ≥ 0.14 logMAR), except Fernández, which remained Smooth, and Armengol 2020a, which shifted to Steep at 4.0 mm. Conclusions: Visual acuity prediction models provide useful means of reporting optical bench data in clinically familiar metrics. However, outcomes should be interpreted with caution as functional classifications can vary depending on the optical bench setup and prediction model used. Full article

Background: Intraocular lens (IOL) alignment is crucial for optimal performance in presbyopia-correcting designs. The aim was to report a case of a patient with a high angle kappa implanted with the continuous transitional focus (CTF) Precizon Prebyopic NVA IOL. Case presentation: A 51-year-old patient presenting large angle kappa values (0.6/0.8 mm) was implanted with the Precizon Prebyopic NVA IOL and followed-up 1 and 10 months post-surgery. This IOL is designed with a butterfly-shaped central area that allows the orientation of the lens so that the visual axis passes through the wider diameter of the optic zone. Postoperative refraction was −0.25D of cyl at 80° for the right eye and +0.25D −0.50D cyl at 170°. Corrected distance visual acuity (CDVA) at the last visit was −0.1 logMAR monocularly and −0.2 logMAR binocularly. Binocular uncorrected distance (UDVA), intermediate (UIVA) and near visual acuities (UNVA) were −0.1, 0.1 and 0.1 logMAR, respectively. The corrected binocular defocus curve exhibited outstanding vision at the 0.00D defocus level and showed a continuous range of functional vision from distance to near. Overall excellent satisfaction was reported, along with low levels of photopic phenomena. Conclusions: Precizon Presbyopic NVA IOL provided satisfactory vision and low levels of photic phenomena in a high angle kappa patient who would potentially be excluded from presbyopia-correcting IOL implantation. Full article

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of visual impairment in older adults and often coexists with cataracts. The indication of presbyopia-correcting intraocular lenses (IOLs) in these patients remains controversial. This study aimed to evaluate the clinical performance of a non-diffractive extended depth-of-focus (EDOF) IOL (LuxSmart™) compared to a monofocal plus IOL (Tecnis Eyhance™) in cataract patients with early-stage dry AMD. Methods: In this prospective observational study, 41 patients with early-stage AMD underwent bilateral cataract surgery with either LuxSmart™ or Tecnis Eyhance™ IOL implantation, targeting postoperative emmetropia. The eye selected for analysis was the first eye scheduled for surgery. Preoperative and postoperative evaluations included high and low-contrast distance visual acuity, intermediate and near visual acuity, defocus curves, ocular light scatter (halometry), and quality of life assessment (NEI VFQ-25). Postoperative biometric accuracy and refractive outcomes were also analyzed. Results: Both IOLs showed high refractive accuracy, with 100% of eyes within ±0.50 D of target. Postoperative uncorrected distance visual acuity was 0.10 ± 0.06 LogMAR for Eyhance and 0.07 ± 0.02 for LuxSmart (p = 0.06). Low contrast VA at 20% was 0.22 ± 0.11 (Eyhance) and 0.26 ± 0.16 (LuxSmart) (p = 0.49). Depth of focus was approximately 1.75 D for both lenses. Light scatter (LDI) improved postoperatively in both groups with no significant differences (p = 0.54). VFQ-25 scores showed improvement in daily activities, though no changes were observed in driving or mental health domains. Conclusions: Both lenses are safe and effective options for early AMD patients undergoing cataract surgery, providing good functional vision at multiple distances Full article

Background/Objectives: The Tecnis Eyhance is an enhanced monofocal intraocular lens (IOL) designed to improve intermediate vision without compromising distance clarity or increasing the incidence of photic phenomena. Although short-term results have been encouraging, long-term data remain limited. This study presents the 5-year follow-up of a previously published 6-month clinical evaluation, aiming to assess the stability of visual, optical, and patient-reported outcomes over time. Methods: A single-center retrospective study of 18 patients (36 eyes) undergoing bilateral Tecnis Eyhance IOL implantation was conducted. The same cohort from the original 6-month study was re-evaluated after a mean follow-up of 5 years. Visual acuity (distance, intermediate, near), defocus curves, contrast sensitivity, optical quality, effective lens position (ELP), halo size, and patient-reported measures were assessed. Results: Visual acuity remained stable across all distances, with binocular uncorrected intermediate visual acuity (UIVA) ≤ 0.2 logMAR in all patients. No significant changes were observed in optical quality parameters or contrast sensitivity. ELP remained consistent over time (p = 0.298), and posterior capsule opacification (PCO) requiring Nd:YAG capsulotomy developed in 5% of the eyes. Halo size was mild, and subjective glare perception did not increase. Spectacle independence remained high for distance (100%) and intermediate (more than 75%) tasks. Conclusions: This 5-year follow-up study confirms the long-term stability and effectiveness of the Tecnis Eyhance IOL. These findings support its long-term use as a stable monofocal IOL with enhanced intermediate function. Full article

Background: Spectacle independence is a key goal in refractive lens exchange (RLE), especially in younger, high-expectation patients. This study evaluates a novel extended monovision approach combining a monofocal aspheric intraocular lens (IOL) in the dominant eye with a rotationally asymmetric bifocal extended-depth-of-focus (EDOF) IOL in the non-dominant eye. The strategy aims to optimize full-range visual performance while minimizing photic phenomena. Methods: In this retrospective cohort study, presbyopic patients underwent bilateral RLE with a monofocal IOL (Hoya Vivinex XC1-SP; target: 0 diopters [D]) in the dominant eye and a rotationally asymmetric bifocal EDOF IOL (LENTIS LS-313 MF15; addition: +1.5 D; target: −1.25 D) in the non-dominant eye. Uncorrected distance visual acuity (UDVA, at 6 m), uncorrected intermediate visual acuity (UIVA, at 66 cm), and uncorrected near visual acuity (UNVA, at 36 cm) were assessed. Additional evaluations included binocular defocus curves, contrast sensitivity, stereoacuity, and photic phenomena. Spectacle independence and satisfaction were measured using the PRSIQ and NEI-RQL-42 questionnaires. Results: A total of 38 patients (76 eyes) were included. The mean postoperative binocular UDVA, UIVA, and UNVA were −0.03 ± 0.08, −0.08 ± 0.09, and 0.04 ± 0.08 logMAR, respectively. The defocus curve peaked at 0.0 D (6 m) with a mean visual acuity of −0.03 ± 0.08 logMAR. Functional vision better than 0.2 logMAR extended over defocus steps from +1.00 to −3.25 D. All patients were spectacle-independent for distance and intermediate vision, and 84% reported complete spectacle independence. Contrast sensitivity was within normal limits for age. Minimal photic phenomena were reported, and stereoacuity was preserved in 97% of patients (≤100 arcseconds). Conclusions: This innovative extended monovision approach, combining two different IOLs in a mini-monovision setup, provides excellent uncorrected visual acuity at all distances, high spectacle independence, and minimal side effects. It represents a compelling alternative to multifocal IOL implantation in presbyopic RLE candidates. Full article

Background/Objectives: A new, purely refractive extended depth-of-focus (EDOF) intraocular lens (IOL) was designed with a continuous change in power to bridge the gap between monofocal and multifocal IOLs. This study aimed to evaluate the real-world clinical outcomes of the new EDOF IOL compared with those of the enhanced monofocal IOL. Methods: A retrospective analysis was conducted on 100 eyes from 50 patients undergoing bilateral cataract surgery with either the PureSee™ EDOF (ZEN00V) or Eyhance™ (ICB00) monofocal IOL at a single institution. Visual acuity, defocus curves, contrast sensitivity, and patient-reported outcomes were evaluated three months postoperatively. Results: The ZEN00V group demonstrated superior uncorrected intermediate (0.11 ± 0.08 vs. 0.17 ± 0.11 logMAR, p = 0.006) and near visual acuity (0.25 ± 0.08 vs. 0.31 ± 0.13 logMAR, p = 0.023) compared to the ICB00 group, with comparable distance visual acuity. Both groups exhibited comparable defocus curves and contrast sensitivity. While photic phenomena were more frequent in the ZEN00V group, spectacle dependence was significantly lower for near vision (36% vs. 80%, p = 0.002) and comparable for intermediate and far vision. Conclusions: The PureSee™ EDOF IOL demonstrated enhanced intermediate and near vision with minimal compromise to distance vision while maintaining high contrast sensitivity. It also offered significant spectacle independence and patient satisfaction, making it a promising option for presbyopia correction. Full article

Background/Objectives: This study aimed to evaluate the visual quality and symptomatology of a non-diffractive extended depth-of-focus (EDoF) intraocular lens (IOL), the Elon 877PEY (Medicontur, Zsámbék, Hungary), three months after implantation. Methods: A cross-sectional case series study was conducted, with measurements taken three months post-implantation of the Elon IOL. A total of 56 implanted eyes from 28 patients (mean age: 64.5 ± 9.5 years) were included in the statistical analysis. The variables analyzed to assess the effectiveness of the Elon IOL included high-contrast visual acuity, contrast sensitivity, the defocus curve, and visual symptoms. Results: Three months after implantation, the mean residual sphere was 0.00 ± 0.33 D, while the mean residual cylinder was −0.25 ± 0.41 D. Without correction, patients achieved monocular decimal visual acuity values of 0.94 ± 0.26 for distance, 0.79 ± 0.17 for intermediate, and 0.58 ± 0.15 for near vision. The mean uncorrected contrast sensitivity was 1.61 ± 0.15 log. The defocus curve showed visual acuity exceeding 0.80 decimal (0.10 logMAR) over a 2.00 D range and above 0.63 decimal (0.20 logMAR) over a 2.50 D range. The most frequently reported symptoms, with mild severity and bothersomeness, were glare, starbursts, halos, and focusing difficulties. Conclusions: Patients implanted with the Elon IOL achieved satisfactory visual quality at all distances, comparable to outcomes reported for other EDoF IOLs in the scientific literature. Full article

Purpose: A novel enhanced monofocal intraocular lens (IOL) has been developed to improve functional intermediate vision, maintaining a distance vision comparable to a standard monofocal lens and avoiding the drawbacks of multifocal IOLs. The aim of this study is to perform optical bench analysis and to evaluate refractive and visual outcomes and patient satisfaction. Methods: This prospective comparative single-center study was conducted in Careggi Hospital, University of Florence (Italy). We included 100 eyes from 50 patients who underwent bilateral cataract surgery. One group received the standard monofocal Tecnis GCB00 IOL, while the other group received the novel enhanced monofocal Evolux IOL. We evaluated binocular visual and refractive outcomes at 6 months after surgery. Binocular defocus curves and contrast sensitivity (CS) were also assessed. Optical quality was also analyzed in terms of higher-order aberrations (HOAs), modulation transfer function (MTF), objective scatter index (OSI), Strehl ratio, effective lens position (ELP), and halo analysis. A Patient-Reported Spectacle Independence Questionnaire (PRSIQ) was performed to assess spectacle independence outcomes. Finally, we analyzed the optical bench of both lenses. Results: All eyes implanted with Evolux achieved excellent distance vision, comparable to that achieved with GCB00. Evolux showed better intermediate and near vision, without any loss of visual quality, contrast sensitivity, or the presence of halos and photic phenomena. The optical bench analysis confirmed the different optical properties of the two lenses and supported the behavior obtained with the clinical defocus curve. Conclusions: These preliminary results show good refractive accuracy and visual outcomes for the enhanced monofocal IOL Evolux after cataract surgery. Further studies are needed to confirm our findings in terms of the number of patients and the period of follow-up. Full article

Background/Objectives: This study aimed to compare the visual outcomes of two diffractive trifocal intraocular lenses (IOLs): the Bi-Flex Liberty 677MY (Medicontur; Zsámbék, Hungary) and the FineVision POD F (BVI Medical; Waltham, MA, USA). Methods: A prospective study with a 3-month follow-up was conducted. A total of 62 patients were divided into two groups according to the type of lens implanted: 31 patients with the Liberty lens (61.1 ± 6.4 years) and 31 patients with the Finevision lens (61.9 ± 6.8 years). Three measurement sessions were conducted (baseline, 1 month, and 3 months). These sessions included measurements of the subjective refraction, visual acuity, and defocus curve. Both eyes of each patient were operated on and included in the statistical analysis. Results: Three months after surgery, monocular visual acuity with the Liberty lens was statistically greater than with the Finevision lens at defocus values of −2.00 D (50 cm) and −2.50 D (40 cm) (p < 0.01). In this regard, the near visual acuity results (40–50 cm) with the Liberty lens showed greater variability compared to those of the Finevision lens. Binocularly, however, the Finevision lens demonstrated a statistically significant improvement in visual acuity than the Liberty lens at a defocus of −1.50 D (67 cm) (p = 0.01). Both IOLs provided visual acuities better than 0.20 logMAR for a defocus range from distance (0.00 D) to near (−3.50 D). Conclusions: Future studies are needed to investigate which patient ocular parameters could predict improved near vision with the Liberty lens or intermediate vision with the Finevision lens. Full article