Visual Psychophysics / Physiological Optics - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological OpticsDaniel H. Chang 1 , Elizabeth A. Davis 2 . 1 Empire Eye and LaserCenter, Bakersfield, CA; 2 Minnesota Eye Consultants, Bloomington,MN.Purpose: To evaluate clinical outcomes, patient satisfaction, andsurgeon satisfaction following bilateral implantation of theTECNIS® Multifocal 1-Piece IOL (ZMB00).Methods: On-going, prospective, open-label observational trial fromsurgeons performing cataract surgery and bilateral TECNIS®Multifocal (TMF) 1-Piece IOL implantation in qualified subjectsaged 21 years or older. All eyes had preoperative corneal astigmatismof < 1.0 D. Visual acuity (distance, intermediate, near) and patientsatisfaction questionnaires were collected at the 3-4 monthpostoperative visit. Surgeon assessment questionnaires were taken at3 months and at one year.Results: Interim data were collected on 106 subjects with a mean ageof 66.0 ± 8.1 years. Mean postoperative sphere was 0.07 ± 0.47 Dwith 0.40 ± 0.39 D of cylinder and a spherical equivalent of +0.05 ±0.47 D. Mean binocular UCVA was 20/23 at distance, 20/30 atintermediate and 20/22 at near. Mean binocular DCVA was 20/20 atdistance, 20/28 at intermediate, and 20/21 at near. The percentage ofsubjects with UCVAs of 20/32 or better was 91.8% for distance,67.7% for intermediate, and 93.8% for near. The percentage ofsubjects with DCVAs of 20/32 or better was 98.8% for distance,70.9% for intermediate, and 96.6% for near. At 3-4 monthspostoperative, 86.9% of subjects never or hardly ever use glasses,87.9% of subjects were either satisfied or very satisfied with theiroverall vision without glasses, and 81.3% of subjects would mostlikely choose this lens again. At the 3 months, 78.5% of surgeons feltcomfortable with the TMF after implanting ≤ 6 lenses, and 92.9% ofsurgeons would recommend the TMF to family, friends, andcolleagues. At one year, 86% of top enrollers were still using theTMF.Conclusions: Subjects receiving the TECNIS® Multifocal 1-PieceIOL showed high levels of satisfaction with good visual outcomes atall distances and minimal postoperative refractive error. Surgeonreportedexperience and perception of the TMF were highly positive.This experiential data further corroborates the U.S. FDA clinicalstudy results.Commercial Relationships: Daniel H. Chang, Abbott MedicalOptics, Inc. (F), Abbott Medical Optics, Inc. (C), Abbott MedicalOptics, Inc. (R); Elizabeth A. Davis, NoneSupport: Abbott Medical Optics, Inc.Program Number: 834 Poster Board Number: B0058Presentation Time: 1:00 PM - 2:45 PMLight Transmittance of Explanted Hydrophobic AcrylicIntraocular Lenses with Surface Light ScatteringLiliana Werner 1 , Caleb Morris 1 , Shannon Stallings 1 , Erica Liu 1 , AnneM. Floyd 1 , Andrew Ollerton 1 , Lisa Leishman 1 , Zachary Bodnar 1 ,Marcia Ong 2 , Ali Akinay 2 . 1 Ophthalmology, John A. Moran EyeCenter, University of Utah, Salt Lake City, UT; 2 Alcon Laboratories,Fort Worth, TX.Purpose: Surface light scattering on hydrophobic intraocular lenses(IOLs) is caused by hydration-related subsurface nanoglisteningswithin the acrylic IOL material. The aim of this study was toinvestigate the potential effect of surface light scattering on the lighttransmittance of single-piece hydrophobic acrylic IOLs made ofAcrySof material (Alcon) with or without blue light filter (BLF).Methods: IOLs were obtained from human cadavers (49 lenses total;36 with BLF), and from finished-goods inventory (controls). TheIOLs were explanted from the cadaver eyes and power/modelmatched to unused control IOLs. After removing proteins, the IOLswere allowed to hydrate for 24 hours at room temperature. Surfacelight scattering was then measured with a Scheimpflug camera (EAS-1000 Anterior Segment Analysis System, Nidek Ltd). Lighttransmittance was measured with a Perkin Elmer Lambda 35 UV/Visspectrophotometer (single-beam configuration with RSA-PE-20integrating sphere).Results: Hydrated scatter values ranged from 4.8 to 202.5 CCT forexplanted IOLs with BLF and 1.5 to 11.8 CCT for controls; valuesranged from 6.0 to 137.5 CCT for explanted IOLs without BLF and3.5 to 9.7 CCT for controls. In both groups, there was a tendency forincreasing scatter values with increasing postoperative time. Nodifferences in light transmittance were observed between explantedIOLs and controls for both groups of lenses (BLF IOLs: P=0.407,Paired T-Test; Non BLF IOLs: P=0.216, Wilcoxon Signed Rank Testfor Paired Data).Conclusions: Although surface light scattering of explanted lenseswas significantly higher than that of controls and appeared to increasewith time, no effect was observed on the light transmittance of singlepiecehydrophobic acrylic lenses with or without blue light filter.Commercial Relationships: Liliana Werner, Aaren Scientific (F),Abbott Medical Optics (F), Advanced Vision Science (F), AlconLaboratories (F), Anew Optics (F), Bausch & Lomb Surgical (F),Calhoun Vision (F), Innovia (F), MRI Research (C), Powervision(C), Rayner Intraocular Lenses (F), Visiogen (C); Caleb Morris,None; Shannon Stallings, None; Erica Liu, None; Anne M. Floyd,None; Andrew Ollerton, None; Lisa Leishman, None; ZacharyBodnar, None; Marcia Ong, Alcon Research (E); Ali Akinay,Alcon Researh, Ltd (E)Program Number: 835 Poster Board Number: B0059Presentation Time: 1:00 PM - 2:45 PMVisual Simulation of Retinal Images through a New AsymmetricRefractive Multifocal Intraocular Lens with Two SphericalSurfacesYuki Hidaka 1 , Kazuno Negishi 1 , Kazuhiko Ohnuma 2 , KazuhiroWatanabe 1 , Hidemasa Torii 1 , Megumi Saiki 1 , Kazuo Tsubota 1 .1 Ophthalmology, Keio University School of Medicine, Shinjuku-ku,Japan; 2 Graduate School of Engineering, Chiba University, Chiba,Japan.Purpose: To evaluate optical performance of an asymmetricrefractive multifocal intraocular lens (MIOL) using a visualsimulation system.Methods: The system consists of a lens that corresponds to a cornea,an IOL in a water cell, and a charge-coupled device (CCD) camera.The images formed by the lens can be detected by the CCD cameraand observed on the monitor of a personal computer. The aperturediameter is exchangeable in the water cell. Using this system, visualsimulations of Landolt visual acuity (VA) charts at various distanceswere performed using the MIOL (LENTIS® Mplus, Oculentis)through a 3.5-mm aperture corresponding to photopic conditions or a4.5-mm aperture corresponding to mesopic conditions. The contrastsof the gaps of large (logarithm of the minimum angle of resolution[logMAR] 0.7), medium (logMAR 0.4), and small (logMAR 0.0)Landolt VA charts in the simulated images were analyzed usingPhotoshop graphics editing software (Adobe).Results: Using the 3.5-mm aperture, the contrasts of the gaps of thelarge, medium, and small charts were 0.22, 0.1, and 0.08 at 5 meters(m) and 0.08, 0.04, and 0.02 at 0.34 m, which was the best nearfocus, respectively. Using the 4.5-mm aperture, the contrasts of thegaps of the large, medium, and small charts were 0.14, 0.07, and 0.03at 5 m and 0.07, 0.04, and 0.01 at 0.34 m, respectively. The largecharts maintained good contrast at all distances through the 3.5-mmaperture. The contrast decreased with decreasing sizes of the Landoltrings, especially at the intermediate distance (from 1-0.5 m). Through©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological Opticsthe 4.5-mm aperture, the results showed a similar trend with degradedcontrasts compared to the 3.5-mm aperture. The typical simulatedimage had an asymmetric blur probably due to the asymmetric MIOLdesign.Conclusions: The asymmetric refractive MIOL provides goodoptical performance at all distances for large charts under photopicconditions, although the optical performance degrades especially atintermediate distance with medium and small charts or undermesopic conditions.Commercial Relationships: Yuki Hidaka, None; Kazuno Negishi,Oculentis (F); Kazuhiko Ohnuma, None; Kazuhiro Watanabe,None; Hidemasa Torii, None; Megumi Saiki, None; KazuoTsubota, AcuFocus, Inc (C), Allergan (F), Bausch Lomb Surgical(C), Functional visual acuity meter (P), JiNS (P), Kissei (F), Kowa(F), Santen, Inc. (F), Otsuka (F), Pfizer (C), Thea (C), Echo Denki(P), Nidek (F), Ophtecs (F), Wakasa Seikatsu (F), CEPT Company(P)Program Number: 836 Poster Board Number: B0060Presentation Time: 1:00 PM - 2:45 PMA novel hydrophilic intraocular lens with lateral walls to preventposterior capsular bag opacificationHiroyuki Matsushima 1 , Koichiro Mukai 1 , Satoshi Watabiki 1 , YokoKatsuki 1 , Jiro Hidaka 2 , Senoo Tadashi 1 . 1 Ophthalmology, DokkyoMedical University, Shimotsuga-Gun, Japan; 2 Hoya Surgical Optics,Tokyo, Japan.Purpose: Previous studies show that equator ring and peripheral ringprevented capsular bag opacification. And another study shows theaqueous humor inhibit lens epithelial cells development. In thisstudy, we made a novel hydrophilic intraocular lense (IOL) withlateral walls. And we evaluated the prevention of posterior capsularbag opacification (PCO) by circulating aqueous humor inexperimental rabbit studies.Methods: NY-60 (HOYA) was remodeled that having 4 lateral walls(2.8mm height, Fig. 1) to expand posterior capsule after implantinginto the lens capsule. And 8 holes around the peripheral of intraocularlens (IOL) optic and 1 each hole in center of the walls were made forrole of aqueous humor circulate into a capsular bag (aqueous humorcirculate IOL; AHC IOL). Eight weeks 6 albino rabbits weighting 2kg were prepared and phacoemulsification in 2.65mm cornealinsertion were performed. Control IOL (NY-60, HOYA) wasimplanted one eye and the AHC IOL was implanted another eye.After 1, 2 and 4 weeks, the IOL and PCO were observed using slitlump and tissue section was stained with hematoxylin-eosin andobserved under light microscope. The PCO was quantified on thebasis of the thickness of the lens epithelial cell layer on the centralsubcapsular area and compared among two groups.Results: After 2 weeks, partial PCO was observed using slit lump incontrol group; however, no significant PCO was observed in AHCgroup. The thickness of developed lens epithelial cells in center ofIOL was 59.4±67.9μm in control group and 8.3±3.2μm in AHCgroup at 4 weeks postoperatively. There is statistically significance(unpaired t-test).Conclusions: Novel AHC IOL prevents PCO in experimental rabbitstudy. A device of IOL shape without well known sharp edge mayprevent PCO.Commercial Relationships: Hiroyuki Matsushima, HOYA (C);Koichiro Mukai, None; Satoshi Watabiki, None; Yoko Katsuki,None; Jiro Hidaka, HOYA Corporation Medical Division (E);Senoo Tadashi, NoneProgram Number: 837 Poster Board Number: B0061Presentation Time: 1:00 PM - 2:45 PMCurvature Changing Accommodating IOLJim Schwiegerling, Sean J. McCafferty, William Duncan. OpticalSciences, University of Arizona, Tucson, AZ.Purpose: To demonstrate the accommodative capabilities of acurvature changing intraocular lens.Methods: We previous demonstrated a concept for anaccommodating IOL in which an elastic material is sandwichedbetween two rigid plates. One of the plates has a small aperturethrough which the soft material can be partially extruded when theplates are compressed. The extruded material takes on a roughlyparabolic shape and consequently imparts optical power to thesystem. Here, we have fabricated a prototype lens consisting of asilicone gel with refractive index of 1.38 and a durometer value of 12units on the “00” scale. The rigid portion of the IOL is fabricatedfrom PMMA. To make the IOL increase in power in response toconstriction of the ciliary muscle, the soft material needs to extrudeinto a higher index fluid. We evaluate a series of liquids, indexedmatched to the PMMA, as well as lower index fluids in the indexrange of 1.44 to 1.48.Results: Compression of 100 microns of the silicone gel over a 3 mmaperture leads to a potential accommodative amplitude of 5.3 to 9.7 Dfor the fluids examined. There is concern of the fluid diffusing intothe silicone gel and a membrane may be needed at this interface.Conclusions: he feasibility of an accommodating IOL based oncurvature change of interface between a low index silicone gel and ahigh index fluid is demonstrated. The power change of the lens modelworks with the accommodation mechanism of the eye.Commercial Relationships: Jim Schwiegerling, Alcon Research(F), Wavetec (F), Visioneering (C); Sean J. McCafferty, None;William Duncan, NoneSupport: NIH Grant EY021847Program Number: 838 Poster Board Number: B0062Presentation Time: 1:00 PM - 2:45 PMA triplet optical design for a wide range accommodative IOLEnrique-Josua Fernandez, Pablo Artal. Laboratorio de Optica,Instituto Universitario de investigación en Óptica y Nanofísica(IUiOyN), Universidad de Murcia, Murcia, Spain.Purpose: Standard intraocular lenses (IOLs) are mostly designed forfar distance vision. Although accommodative IOLs have been©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
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