ObjectiveTo examine differences in individual retinal layer thicknesses measured by spectral domain optical coherence tomography (SD-OCT) (Spectralis®) produced with age and according to sex.DesignCross-sectional, observational study.MethodsThe study was conducted in 297 eyes of 297 healthy subjects aged 18 to 87 years. In one randomly selected eye of each participant the volume and mean thicknesses of the different macular layers were measured by SD-OCT using the instrument's macular segmentation software.Main outcome measuresVolume and mean thickness of macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigmentary epithelium (RPE) and photoreceptor layer (PR).ResultsRetinal thickness was reduced by 0.24 μm for every one year of age. Age adjusted linear regression analysis revealed mean GCL, IPL, ONL and PR thickness reductions and a mean OPL thickness increase with age. Women had significantly lower mean GCL, IPL, INL, ONL and PR thicknesses and volumes and a significantly greater mRNFL volume than men.ConclusionThe thickness of most retinal layers varies both with age and according to sex. Longitudinal studies are needed to determine the rate of layer thinning produced with age.

To evaluate depth of field (DOF) provided by different presbyopia-correcting intraocular lens (IOL) designs, comparing the results obtained using different criteria for defining the defocus tolerance. A total of 150 eyes undergoing cataract surgery were enrolled and divided into 6 groups depending on the IOL implanted: AT.LISA Tri (Carl Zeiss Meditec), FineVision (PhysIOL), PanOptix (Alcon Laboratories), Tecnis Symfony (Johnson & Johnson Vision), Miniwell (SIFI MedTech) and Tecnis Synergy (Johnson & Johnson Vision). Subjective DOF was obtained from defocus curves with absolute and relative criteria of tolerance of 0.1 logMAR. Aberrometry was also measured and the visual strehl optical transference function (VSOTF) with percentage of degradation of 90%, 80% and 60% was used to quantify objectively the DOF. Tecnis Symfony, Tecnis Synergy and Panoptix IOL groups showed better subjective and objective DOF compared to the rest of IOL groups, being these differences statistically significant differences (p < 0.001). Comparison between subjective and objective DOF showed that subjective measures were higher for all IOLs, being also these differences statistically significant for all groups (p < 0.001). A moderate significant correlation was found between absolute subjective criteria and VSOTF60% (r = 0.73, p < 0.05). Objective and subjective measures of DOF are not comparable due to differences in methodologies and criterions to define the level of degradation tolerance. Nevertheless, both objective and subjective measures showed a trend to a greater DOF for Tecnis Symfony and Tecnis Synergy IOLs compared to most of trifocal diffractive designs, with the exception of PanOptix.

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To assess the effectiveness and safety of the Preserflo Microshunt (PMS) implantation combined with cataract surgery in open-angle glaucoma (OAG) patients. Retrospective, open-label study conducted on insufficiently controlled OAG patients, who underwent a PMS implant procedure with mitomycin-C 0.2%, either alone or in combination with cataract surgery, and were followed for at least 12 months. Success was defined as an intraocular pressure (IOP) ≤ 18 mmHg and a reduction of at least 20% without (complete) or with (qualified) hypotensive medication. Fifty-eight eyes were included in the study, 35 eyes underwent PMS alone and 23 underwent PMS + Phaco. In the overall study sample, mean IOP was significantly lowered from 21.5 ± 3.3 mmHg at baseline to 14.6 ± 3.5 mmHg at month 12 (p < 0.0001). The IOP was significantly reduced in both groups; p < 0.0001 each, respectively. Ocular hypotensive medication was significantly reduced (p < 0.0001) in both groups. No significant differences were observed in IOP lowering or medication reduction between groups. At month 12, 62.1% eyes were considered as complete success and 82.8% eyes as qualified success. The most common adverse events were device close-to-endothelium, conjunctival fibrosis, and wound leakage. PMS, either alone or in combination with phacoemulsification, may be considered as a valuable option for treating OAG patients.

Purpose: To evaluate the refractive and functional outcomes of the trifocal 1stQ AddOn ® (Medicontur) supplementary intraocular lenses (IOLs) designed for implantation into the ciliary sulcus. Patients and Methods: The study included 18 eyes of 11 pseudophakic patients with uncomplicated previous implantation of monofocal capsular bag IOLs. These patients had a desire for spectacle independence. Distance, intermediate and near visual acuities were measured, and defocus curves were plotted over a period of 6 months following implantation of the add-on IOLs. Intraocular pressure (IOP), endothelial cell density measurements and biomicroscopic evaluation were also performed. Results: In this study, 83.3% of eyes had spherical refractions within ±0.5 D from emetropia and 100% of eyes had spherical equivalent refractions that were within ±1.0 D of the target refraction. Visual acuities and defocus curves clearly confirmed trifocal optical performance (UDVA=0.03 ±0.05; UIVA=0.21 ±0.04; UNVA=0.12 ±0.04 logMAR; expressed as mean ±SD). Depth of focus showed identical results (DOF=0.486 D) compared to a trifocal capsular bag IOL, while the defocus curve was found to be superior in the intermediate and near ranges when compared to a trifocal capsular bag IOL. All patients achieved spectacle independence at all distances. All add-on IOLs were well positioned in the ciliary sulcus. No negative changes were noted in connection with endothelial cell counts, IOPs, the angle structure during surgery and during the follow-up period. Conclusion: The supplementary trifocal add-on IOL seems to be a safe, efficient and stable solution for achieving spectacle independence in pseudophakic patients with monofocal primary IOLs.

Segmented macular layer analysis shows a good capacity to discriminate between normal and glaucomatous eyes; which is comparable to that of cpRNFL analysis in children with PCG.

Purpose: To evaluate the refractive predictability obtained with an extended range of vision intraocular lens in eyes with previous myopic laser in situ keratomileusis, confirming which intraocular lens power formula provides the most accurate calculation. Methods: The study enrolled 71 eyes with previous successful myopic laser in situ keratomileusis surgery of 43 patients undergoing cataract surgery with implantation of the extended range of vision intraocular lens TECNIS Symfony (Johnson and Johnson Vision). Intraocular lens power was calculated using all American Society of Cataract and Refractive Surgeons formulas, and their average value was selected for implantation. Refractive outcomes were evaluated at 3 months postoperatively. Results: Postoperative spherical equivalent within ±0.50 and ±1.00 D was found in 61.6% and 86.3% of eyes, respectively. In eyes with pre-laser in situ keratomileusis data available, no significant correlation was found between pre-laser in situ keratomileusis spherical equivalent and post-cataract surgery spherical equivalent (r = 0.237, p = 0.114). A postoperative spherical equivalent within ±0.50 D was found in 65.2% and 55.6% of eyes in the subgroups with and without pre-laser in situ keratomileusis data available, respectively (p = 0.480). Statistically significantly higher differences between the intraocular lens power implanted and the calculation provided by the Potvin–Hill (p = 0.028) and Barrett True K No History formulas (p = 0.022) were found in those eyes with postoperative spherical equivalent > 0.50 D. Conclusion: The extended range of vision intraocular lens evaluated can provide a predictable refractive correction in eyes with previous laser in situ keratomileusis surgery. The Potvin–Hill and Barrett True K No History are the most adequate formulas to perform intraocular lens power calculations in these cases.

Purpose To assess the depth of field (DOF) by means of defocus curve analysis applying different visual acuity criteria in patients following cataract surgery and bilateral implantation of a new trifocal diffractive intraocular lens (IOL). Methods Fifty eyes of 25 consecutive patients who underwent implantation of the Asqelio™ trifocal IOL (AST Products Inc., USA) were enrolled in this observational prospective study. Monocular subjective DOF was obtained from defocus curves with absolute and relative criteria of tolerance for different visual acuities values. Patient’s visual satisfaction, postoperative refraction and visual acuity at far, intermediate (67 cm) and near (40 cm) distances were also measured at 1 and 3-months post-surgery. Analysis of variance was used to assess differences in refractive error after the surgical procedure, and paired t-tests were used to assess differences in VA. Patient satisfaction results were reported as percentages. Results Spherical equivalent was 0.05 ± 0.23 D and residual cylinder 0.01 ± 0.23 D 3-months after the surgery. Absolute DOF obtained was 3.29 ± 0.91 D considering 0.1 LogMAR as cut-off value, and 4.82 ± 0.69 D when 0.3 logMAR as cutoff value. Relative DOF considering a drop of 0.1 logMAR from maximum visual acuity was 2.57 ± 0.82 D, and 1.27 ± 0.70 D when a drop of 0.04 logMAR was considered. Visual acuities obtained 3-months after the surgery were 0.03 ± 0.13, − 0.05 ± 0.06, 0.03 ± 0.08 and 0.04 ± 0.08 logMAR for uncorrected and best-corrected for distance, and best distance-corrected for intermediate and near distances, respectively. Average response to visual satisfaction queries was 8.24/10 at distance, 8.04/10 at intermediate, and 7.88/10 at near. Conclusions Patients implanted with this trifocal IOL showed a significant improvement in visual acuity at different distances providing wide absolute and relative DOF values. The outcomes demonstrate that this lens is predictable yielding good patient satisfaction rates.