Search Results (45)

Objectives: To evaluate the safety and efficacy of the simultaneous implantation of a monofocal capsular bag-fixated and a trifocal supplementary sulcus-fixated intraocular lens (duet procedure) in eyes with co-existing pathologies undergoing cataract or refractive lens surgery. Methods: In total, 80 eyes of 40 consecutive patients, who underwent refractive lens exchange or cataract surgery and received the duet procedure due to minor co-pathologies, were included in this retrospective case series. Preoperative assessment comprised slit-lamp biomicroscopy, optical biometry, posterior-segment optical coherence tomography, corneal endothelial specular microscopy, corneal tomography, manifest refraction and distance and near visual acuity testing. Three months postoperatively, uncorrected distance (UDVA) and uncorrected near visual acuity (UNVA) were recorded. Results: The preoperative manifest refractive spherical equivalent (MRSE) was −0.31 ± 4.29 diopters (D), with a mean refractive astigmatism of −0.80 ± 0.60 D. At three months postoperatively, monocular UDVA and binocular UNVA significantly improved from 0.52 ± 0.42 logMAR and 0.32 ± 0.27 logMAR to 0.05 ± 0.09 logMAR and −0.03 ± 0.10 logMAR, respectively (both p < 0.0001). Conclusions: Reversible multifocality provided by the duet procedure appears to be a feasible option in eyes with mild co-existing pathologies, as it yields satisfactory visual and refractive outcomes with high safety. Full article

Objectives: To determine how optometrists in Canada manage their pediatric myopia patients and to assess whether this has changed over time. Methods: In a retrospective chart review, records for children aged 6–10 years who had an eye exam between 2017 to 2021 were reviewed. Children were grouped by presenting refraction (myopes ≤ −0.50 D or pre-myopes ≤ +0.75 D). Up to five unique patients were selected for each age (6, 7, 8, 9, and 10) and initial visit year (2017 to 2021) for each group (myopes and pre-myopes), for a maximum of 250 files per practice. Demographic information, refraction, and recommended interventions were recorded. Logistic regression was used to model the likelihood of being prescribed a myopia control intervention based on patient and optometrist characteristics. Results: A total of 2905 patients (n = 1467 (50%) female) from 15 practices across Ontario, Canada, were included, accounting for 8546 visits. Optometrists predominantly prescribed single-vision spectacle correction as a first-line intervention for myopic children, although this declined from 98.2% in 2017 to 56.7% in 2023. The use of myopia control modalities increased from 1.8% to 43.3% over this same period. Optometrists began recommending myopia control at lower myopic refractive errors over time (−2.63 DS in 2017 vs and −1.49 DS in 2020). Myopia control spectacles were the most commonly prescribed intervention, despite the observation that optometrists are not hesitant to fit contact lenses in younger children. Optometrists who had been in practice longer were more likely to prescribe older forms of myopia control (e.g., bifocals/progressives) than more recent graduates. Conclusions: While single-vision spectacle correction remains a primary approach for initial myopia management in Ontario, Canada, optometrists increasingly recommend myopia control and are initiating interventions earlier. Full article

Purpose: The aim of this study was to compare the one-year efficacy of three spectacle lens designs, highly aspherical lenslets (HALs), horizontally asymmetric peripheral defocus (HAPD) lenses, and standard single vision lenses (SVLs) in slowing myopia progression in school-aged children. Methods: In this prospective, non-randomized study, 57 children, aged 8–17 years, were grouped based on the type of lenses worn: HAL (n = 16), HAPD (n = 21), or SVL (n = 20). Comprehensive ophthalmologic examinations were performed at baseline, 6 months, and 12 months. Outcome measures included spherical equivalent refraction (SER), spherical refraction (SR), cylindrical refraction (CR), and axial length (AL). Data were analyzed using non-parametric tests with significance set at p < 0.05. Results: All groups showed some progression in SER and AL over 12 months. The HAL group demonstrated the smallest median SER change (−0.3 D), compared to HAPD (−0.5 D) and SVL (−0.4 D), though group differences were not statistically significant (p = 0.111). Axial elongation was significantly lower in the HAL group (0.1 mm, IQR: 0.0–0.2 mm) compared to HAPD and SVL (both 0.2 mm, p < 0.0001). CR remained stable in all groups, with no clinically meaningful changes. The HAPD groups showed no advantages over SVL in any parameter. Conclusions: Among the three lens types studied, HAL lenses were the most effective in reducing both refractive and axial myopia progression over 12 months. These findings support their use as a reliable intervention in pediatric myopia control. Full article

The research aims to compare the dynamic visual acuity (DVA) in myopic adults wearing spectacles prescribed to 0.05D and 0.25D steps. This double-blind, randomized, self-control study included 40 myopic participants aged 18–40. The participants were randomly assigned to receive spectacles with one 0.05D step lens and the contralateral lens of 0.25D step. The monocular horizontal and vertical motion DVA at 20 and 40 degrees per second (dps) was measured. The DVA was compared between eyes with 0.25D and 0.05D step lenses and further analyzed by eye dominance and test sequence. The result demonstrated no significant difference in DVA between two eyes with 0.25D or 0.05D step lenses at 20 and 40 dps horizontal and vertical motion test (p > 0.05, respectively). When the eye with a 0.25D step lens was the dominant eye (p = 0.004) or measured secondly (p = 0.002), it outperformed the contralateral eye with a 0.05D step lens in the 40 dps horizontal motion test. In conclusion, the horizontal and vertical motion DVA of the eye with 0.05D step lens spectacles was comparable to that of contralateral eyes corrected with 0.25D step lens. Full article

Background: The World Health Organization defines myopia as a global epidemic. Its growing prevalence and the increasingly early age onset all raise a major concern for public health due to the elevated risk of loss and deterioration of visual function as a result of myopia-related ocular pathological complications. However, it remains unclear whether the vision-related quality of life of patients with myopia is the same as in healthy individuals. The aim of the present study is to assess the quality of life in children and adolescents with myopia between the ages of 8 and 16 years, who underwent observation at USBOBAL-Varna. Methods: This study prospectively included 190 patients with myopia between −1.00 and −5.50 D, corrected with different optical aids. After a thorough physical ocular examination and inquiry into the best visual acuity with and without distance correction, specially designed questionnaires were completed by the patients and their parents/guardians for the purpose of the study. The data from the questionnaires was statistically processed. The mean age of the patients in the study was 11.65 years, 101 were female and 89 were male. Of these, 83 wore monofocal glasses, 50 were monofocal and 47 were multifocal contact lenses, and 10 wore ortho-K lenses. Results: No significant difference in best corrected visual acuity (BCVA) was found among the three types of optical correction (p-value > 0.05). Cronbach’s alpha of the questionnaire for all 10 factors was higher than 0.6, indicating acceptable internal consistency. Significantly higher scores were reported for overall, near, and distance vision, symptoms, appearance, attitude, activities and hobbies, handling, and perception for soft contact lens wearers than for spectacle wearers (p-value < 0.05). Ortho-K wearers performed better than spectacle wearers in all aspects except for pronounced symptoms (p = 0.74). No significant difference was found between ortho-K wearers and soft contact lens wearers for any factor (p > 0.05). Conclusions: Patients wearing spectacles and with myopia above −5.00 D had the highest anxiety scores and lower quality of life among all myopic participants. The research on the quality of life in children with myopia with different refractive errors and optical correction devices is crucial for improving corrective devices and meeting the needs of patients. Full article

Objectives: This study compared the clinical outcomes of Vivinex Impress (XY1-EM) enhanced monofocal and standard Vivinex (XY1) intraocular lenses (IOLs) in mini-monovision cataract surgery. In this retrospective study, patients underwent bilateral implantation with either XY1-EM (33 patients, 66 eyes) or XY1 (24 patients, 48 eyes) in a −1D mini-monovision configuration. Methods: Visual acuity was evaluated from 5 m to 30 cm, along with spectacle dependence, contrast sensitivity, and patient-reported outcomes. Results: The XY1-EM group demonstrated significantly better intermediate and near visual acuity at distances of 30−50 cm (p < 0.05) and reduced spectacle dependence for intermediate distances (p = 0.02). Visual function questionnaire (VFQ-25) scores were significantly higher in the XY1-EM group for general vision, role difficulty, mental health, dependency, and near activity domains (p < 0.05). No significant differences were found in glare, contrast sensitivity, or quality of vision scores. Conclusions: The XY1-EM lens in mini-monovision configuration provides enhanced intermediate and near visual acuity with reduced spectacle dependence compared to standard monofocal IOLs, offering a valuable option for patients seeking improved quality of vision with reduced spectacle use. 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

This study evaluates the optical and thermal performance of near-infrared (NIR)-blocking spectacle lenses at luminous transmittance grades of 0, 2, and 3. Ten lens types were tested, including clear, tinted, and NIR-blocking spectacle lenses (NIBSL). The NIR blocking rate was measured across 780–1100 nm and 1100–1400 nm wavelength bands. Color reproduction was assessed using sharpness (MTF 50), point spread function (PSF), and color accuracy (ΔE₀₀) under 1000 lux outdoor illumination. Thermal insulation was analyzed by monitoring porcine skin temperature at 36 °C and 60 °C under each lens type. As a result, the NIBSL showed better near-infrared blocking performance than other types of lenses in both wavelength ranges, and the coated NIBSL blocked near-infrared more effectively than the polymerized lenses. Compared with other types of lenses, NIBSL showed no difference in object identification, color recognition, and reproducibility, so there is no problem in using them together. Strong correlations were observed between lens surface temperature and underlying pig skin temperature, and inverse correlations between NIR blocking rate and pig skin temperature gradient. These findings confirm that NIBSL offer enhanced protection against NIR-induced thermal effects without compromising optical performance, supporting their use in daily environments for ocular and skin safety. Full article

This article provides an assessment of the impact of different levels of monovision upon early visual outcomes and quality of vision (QoV) following the bilateral implantation of enhanced monovision intraocular lenses (IOLs). Consecutive patients implanted bilaterally with the Rayone EMV (Rayner) were recruited. The dominant eye was targeted for emmetropia, and myopia was targeted in the nondominant eye. Patients were categorized based upon the postoperative refractive outcome in the nondominant eye as follows: Group A: −0.50 to −1.0 D (n = 40), Group B: <−1.00 = D (n = 46). Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuity, and QoV were compared 3 months postoperatively. Binocular UIVA was 0.05 ± 0.10 and −0.01 ± 0.11logMAR (p = 0.03) in the two respective groups, and binocular UNVA was 0.23 ± 0.09 and 0.14 ± 0.09logMAR (p < 0.001). Day QoV was 8.77 ± 1.33 and 8.13 ± 1.34 for night QoV in group A, and 8.85 ± 0.99 and 7.85 ± 1.35, respectively, in group B. Group A had a lower spectacle independence rate of 55% compared to 89.1%. This IOL provides a satisfactory range of vision with high QoV satisfaction. A postoperative refractive error of −1.0 D or more in the nondominant eye significantly improves binocular UIVA, UNVA, and spectacle independence, without negatively impacting QoV. Full article

Background: The objective was to preliminarily evaluate the short-term clinical outcomes obtained in presbyopic patients with a novel, multifocal, customized corneo-scleral contact lens (CSCL). Methods: A total of 11 presbyopic subjects (age 45–80 years, corrected-distance visual acuity ≤ 0.1 LogMAR, near addition ≥ +1.00 D) were recruited and fitted with a multifocal corneo-scleral contact lens in this pilot study. Pre-fitting evaluations included stereopsis, contrast sensitivity (CS), and ocular aberrometry, with follow-up assessments conducted at 20 min and 1-month post-fitting. The defocus curve was also measured to assess visual performance across varying distances. Results: Twenty-two eyes from 11 participants (53.9 ± 4.7 years, 10 female) were included in this study. Significant changes were observed post-fitting for primary and secondary spherical aberration, coma, and stereopsis (p ≤ 0.033). No significant changes in Strehl ratio and total root mean square were detected (p ≥ 0.182). Binocular contrast sensitivity was better with spectacles than with the fitted CSCL at all frequencies (p ≤ 0.048), but the change in monocular did not reach statistical significance for 18 cycles per degree (p = 0.109). All patients and 90.9% of patients achieved a visual acuity of 0.0 LogMAR or better at distance and at intermediate, respectively, and 91.8% achieved 0.3 LogMAR or better for near vision. Conclusions: The customized CSCL evaluated provided functional recovery of visual quality across distances, with acceptable reductions of CS and stereopsis that are comparable to those reported for other multifocal contact lenses. Full article

Background and Objectives: Scleral lenses are widely used for visual rehabilitation in keratoconus patients, but their long-term effects on corneal tomography remain unclear. This study aims to evaluate the impact of 12-month scleral lens wear on corneal tomography in keratoconus patients through a case-controlled design. Materials and Methods: This retrospective study included 220 keratoconus patients, of whom 10 eyes were treated with SoClear (Brighten Optix Corporation, Taipei, Taiwan) mini-scleral lenses for over one year (SL group). A control group of 14 eyes was matched using Mahalanobis distance matching based on anterior maximum keratometry (K_max) and age. Both groups were evaluated at baseline and 12 months. Corneal tomography was assessed using the Pentacam HR (Oculus, Wetzlar, Germany), analyzing parameters such as anterior and posterior corneal curvature, thinnest corneal thickness (TCT), and higher-order aberrations. Generalized estimating equations (GEEs) were employed to assess the time-by-treatment effect between the two groups. Results: The SL group included 10 eyes from eight patients (seven males, one female; mean age 30.40 ± 6.52 years), while the control group included 14 eyes from 11 patients (three males, wight females; mean age 27.43 ± 8.11 years). Best corrected visual acuity with spectacles improved significantly with scleral lenses (p = 0.011) and remained stable (p = 0.044) at 12 months. Significant interaction effects were found in Ambrósio relational thickness (p = 0.006), posterior radius curvature (p = 0.047), posterior mean keratometry (p = 0.019), posterior flat keratometry (p = 0.023), and thinnest corneal thickness angle (p = 0.023); the SL group demonstrated less progression in these parameters compared to the control group. Conclusions: This case-controlled study highlights the 12-month impact of scleral lenses on keratoconus, showing improved visual acuity compared to spectacles, stabilized posterior corneal curvature, and maintained corneal thickness. Further prospective studies with larger cohorts are needed to assess scleral lens effect on keratoconus progression. Full article

Background/Objectives: Asymmetric myopic peripheral defocus lenses (MPDLs) have proven to be effective in slowing the progression of myopia in Spanish children over a period of 12 months. The purpose of this study was to assess the MPDL spectacles’ efficacy in slowing myopia progression over a 24-month period in children. Methods: This study extends the follow-up period of the double-masked, prospective, and randomized clinical trial previously published to 24 months. Children from 6 to 12 years were assigned to two groups: a control group wearing spherotorical single vision lenses (SVLs) or a treatment group wearing MPDL lenses. Inclusion criteria included children with myopia less than −0.50 D, astigmatism below 1.50 D, and best-corrected visual acuity of at least 20/20. Participants underwent cycloplegic autorefractive examination and axial length (AL) measurements at the baseline and six and twelve months in the study already published, and twenty-four months later in the present study. Lifestyle factors, including outdoor activities and digital device use, were also assessed. Baseline characteristics, including age, refractive error, and AL, were comparable between groups. Dropout rates were 15.9%, with 14 participants lost to follow-up, distributed equally between the two groups. Results: After 24 months of follow-up, 69 children remained in this study, comprising 34 participants in the SVL cohort and 35 in the MPDL cohort. Over 24 months, the MPDL group showed significantly less AL elongation than the SVL group (0.27 ± 0.23 mm and 0.37 ± 0.24 mm; p = 0.0341). The mean relative AL increase was 1.10 ± 0.95% in the MPDL group, compared to 1.56 ± 1.02% in the SVL group (p = 0.0322). Younger children exhibited faster AL growth, while digital device use and outdoor activities did not affect AL changes. Conclusions: MPDL spectacle lenses substantially slowed myopia progression over a 24-month period, with 28.7% less progression in absolute AL growth and 29.8% in relative AL growth compared to SVL. These results indicate that MPDL lenses are an effective method for slowing myopia progression. Full article

Using micro-structure components in spectacle lenses has enabled myopia progression control in children and teenagers. However, the optical design of these spectacle lenses has never been discussed, leading to a lack of correct understanding of the underlying optical treatment principles. In this work, array-patterned hexagonal lenslets with two powers of opposite signs were proposed to construct a lenslet array-integrated (LARI) spectacle lens developed for an ongoing, randomized, controlled clinical trial and to support the optical approach to myopia control leveraging retinal image blur. We found that the phase modulation induced by the micro-structures of the lenslet array contributes to the increase in RMS wavefront aberrations, leading to image blur, further inspiring the novel array-patterned micro-structure design with high-order phase elements (HOPEs). The optical performance of both LARI and HOPE spectacle lenses was investigated by simulation and experiment. Full article

Objectives: We aimed to investigate how optometrists in Hong Kong are managing myopic and “pre-myopic” children. Methods: Clinical files for children aged 6 to 10 years old who had eye examinations from 2017 to 2021 were retrospectively reviewed. Children were grouped by the initial spherical equivalent refractive error (SER) as myopes or pre-myopes. The demographic data, refractive error, and myopia management recommended by the optometrists were analyzed. Results: A total of 1,318 children (859 myopes and 459 pre-myopes) from ten clinics in Hong Kong were included. Over 5 years, myopia management recommendations shifted significantly (p < 0.001). In 2017, only 18.4% of children were recommended to pursue myopia control (MC), increasing to 42.8% by 2021. The use of MC spectacle lenses increased from 7.3% in 2017 to 36.8% in 2021, becoming the most recommended option. Orthokeratology, MC contact lenses, and atropine remained stable at less than 5% over this period. Children recommended for MC approaches had significantly more myopia than those recommended single-vision lenses or monitoring (p < 0.05). Age of the first visit significantly correlated with SER change from the first visit to the next recommendation update for pre-myopes (r = 0.27, p = 0.013) but not for myopes. Conclusions: From 2017 to 2021, myopia management patterns in Hong Kong shifted significantly, with more children being recommended for myopia control. MC spectacle lenses emerged as the most commonly recommended method. Younger pre-myopes at their first visit were more likely to have earlier management updates. Full article

Myopia, an increasingly grave public health concern, necessitates the implementation of various techniques for its management. These techniques predominantly comprise the employment of spectacles correction, orthokeratology (ortho-k), and soft bifocal and multifocal lenses. In the present study, a pioneering polish-free ortho-k lens was devised, featuring two reverse lines and three alignment lines, which, respectively, expedite the shaping process and enhance centration. The structural blueprint of the ortho-k lens, along with the simulation of fluorescence staining, was executed employing the FocalPoints software V7.0 (Advance Medical, Milan, Italy). Subsequently, lens aberration elimination was accomplished through ray tracing utilizing ZEMAX software V13.0 (Focus Software, Wixom, MI, USA). The fabrication of the lens was carried out via high-precision lathe turning using the UPC 100 Vision instrument (SCHNEIDER, Ratingen, Germany). The power profile of the ortho-k lens was measured using the CONTEST 2 apparatus (ROTLEX, Omer, Israel). The surface quality was observed under a 200× microscope (ZEISS, Oberkochen, Germany). The fitting of the lens was assessed through the utilization of both Slit-lamp microscopy (MediWorks, Shanghai, China) and Corneal topographer (Medmont E300, Melbourne, VIC, Australia) Full article