Range of refractive independence and mechanism of action of a corneal shape–changing hydrogel inlay: Results and theory

Steinert, Roger F.; Schwiegerling, Jim; Lang, Alan; Roy, Adam; Holliday, Keith; Garza, Enrique Barragan; Chayet, Arturo

doi:10.1016/j.jcrs.2015.08.007

Cited by 16 publications

(17 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Simultaneous vision is normally provided in the form of contact lenses, intraocular lenses or presbyopic LASIK [1,3]. In some cases, extended depth of focus is achieved by increasing aberrations [4][5][6]. Multiple foci may be achieved through diffractive optics, where the design parameters primarily control the power of the lens (to correct for far refractive error), the dioptric distance between the far and near foci (near addition power), and the energy balance between foci [1,3,7].…”

Section: Introductionmentioning

confidence: 99%

Perceived image quality with simulated segmented bifocal corrections

Dorronsoro¹,

Radhakrishnan²,

Gracia³

et al. 2016

Biomed. Opt. Express

View full text Add to dashboard Cite

Bifocal contact or intraocular lenses use the principle of simultaneous vision to correct for presbyopia. A modified two-channel simultaneous vision simulator provided with an amplitude transmission spatial light modulator was used to optically simulate 14 segmented bifocal patterns (+ 3 diopters addition) with different far/near pupillary distributions of equal energy. Five subjects with paralyzed accommodation evaluated image quality and subjective preference through the segmented bifocal corrections. There are strong and systematic perceptual differences across the patterns, subjects and observation distances: 48% of the conditions evaluated were significantly preferred or rejected. Optical simulations (in terms of through-focus Strehl ratio from Hartmann-Shack aberrometry) accurately predicted the pattern producing the highest perceived quality in 4 out of 5 patients, both for far and near vision. These perceptual differences found arise primarily from optical grounds, but have an important neural component.

show abstract

Section: Introductionmentioning

confidence: 99%

Perceived image quality with simulated segmented bifocal corrections

Dorronsoro¹,

Radhakrishnan²,

Gracia³

et al. 2016

Biomed. Opt. Express

View full text Add to dashboard Cite

show abstract

“…[6][7][8] The inlay's index of refraction is very close to that of the cornea. Thus the Raindrop inlay's shape does not induce intrinsic power.…”

mentioning

confidence: 82%

Structural Changes Induced by a Corneal Shape-Changing Inlay, Deduced From Optical Coherence Tomography and Wavefront Measurements

Lang

Holliday

Chayet

et al. 2016

Invest. Ophthalmol. Vis. Sci.

Self Cite

View full text Add to dashboard Cite

PURPOSE. Changes to the anterior stroma and epithelium induced by a meniscus-shaped corneal inlay are presented. The hypothesis that local curvature is a driver of epithelial remodeling is tested. METHODS.Records of 30 subjects enrolled in a prospective clinical investigation of the inlay, implanted in emmetropic presbyopic subjects, were analyzed. The change to the anterior corneal surface was measured using wavefront techniques. The epithelial thinning profile was measured using Fourier domain optical coherence tomography. The stromal change was calculated from the two measurements.RESULTS. The inlay's volume displaced the stroma anterior to the inlay, which was reflected in the change of Bowman's layer shape. The epithelium anterior to the inlay thinned by 18.4 6 7.1 lm. Peripheral to the inlay's diameter (2 mm), circumferential epithelial thickening extended the change to the anterior corneal surface to approximately twice the inlay diameter. The central anterior corneal surface rose by 9.8 6 3.4 lm, creating a progressive add power profile. The epithelial thinning was linearly related to the curvature of the alteration to the anterior surface height, consistent with a theoretical model. CONCLUSIONS.When a meniscus-shaped corneal inlay is placed beneath a corneal flap, the flap's stroma takes on predominately the inlay's shape. The epithelium remodels within a zone approximately twice the inlay diameter, with an anterior corneal height change providing improved near and intermediate vision. The relationship between the epithelial, stromal, and anterior corneal surface changes confirms the hypothesis that epithelial changes are greatest in regions of greater local surface curvature.

show abstract

“…The FDA-approved Raindrop Near Vision Inlay 5 (ReVision Optics, Inc., Lake Forest, CA) remodels the anterior corneal surface, 6 creating a "profocal" add-power profile 7 at the center of the pupil by means of a meniscus-shaped biocompatible hydrogel "spacer" place in the cornea stroma at approximately 30% of the preoperative central corneal thickness. In the stroma, the meniscus-shaped inlay has no optical power because the inlay's index of refraction is the same as the stroma.…”

Section: Resultsmentioning

confidence: 99%