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PubMed2003

[Wavefront analysis and adaptive optics].

In this paper we attempt to provide an overview of the principles of wavefront measurement. We also discuss the operational principles of different systems currently present on the market including their advantages and disadvantages. Moreover, we speculate on current and possible future implications of this new technology in the laser refractive surgery. Adaptive optics are explained in the context of "customized ablation" and preoperative verification of the desired results. Finally, the first international clinical results of wavefront guided excimer laser surgery are reviewed and critically commented.

Equipment Design↗
PubMed1989

Enhanced accuracy is necessary for refractive surgery instrumentation.

New optical zone markers, diamond knives, and gauge blocks were ordered from a random selection of manufacturers and inspected by an independent metallurgical engineer. This study revealed workmanship flaws and poor instrument accuracy. None of the 26 optical zone markers examined came with instructions as to whether the incisions were to be carried to or from the inside diameter or the outside diameter of the corneal impression made by the marker. Two markers had a 100 microns or greater error in their centering devices and one had a centering device off center by 210 microns. Two of the seven diamond micrometer knives had broken blade tips and uneven footplates; two knives had misaligned blades and uneven footplates, one knife had extremely roughly finished footplates, and one knife had a 100 microns error in its micrometer. All the knives had a wobble in the blade shaft upon advancement and had rounded footplates, making blade extension verification difficult. Five of seven blade gauges were accurate to within 10 microns; two had errors of more than 60 microns which could lead to incisions too deep or too shallow and micro- or macroperforations of the cornea during refractive surgery. It is recommended that all refractive surgery instruments be carefully inspected under a high power micron-level microscope at the time of purchase and routinely thereafter.

Keratotomy, Radial↗
PubMed1989

[Control of refraction in cataract surgery].

The optical problems associated with cataract surgery are reviewed and methods to control the refractive state of the eye after the operation are presented. The clinical benefit of a calculation of intraocular lens (IOL) power from measurements of corneal curvature and eye length is demonstrated in a series of operated patients from two Danish eye departments. It is concluded, that the postoperative refraction can be controlled with a reasonable accuracy. Large and unexpected deviations in the postoperative refraction are avoided in this way, and in a number of cases it is possible to reduce the need for spectacles after the operation.

Cataract Extraction↗
PubMed2002

Age-related changes in refractive index distribution and power of the human lens as measured by magnetic resonance micro-imaging in vitro.

We report a new technique for non-invasively mapping the refractive index distribution through the eye lens using magnetic resonance micro-imaging. The technique is applied to map the refractive index distribution throughout the sagittal plane of 18 human eye lenses ranging in age from 14 to 82 years in vitro. The results are compared with standard models for the human eye lens. They confirm that the refractive index distribution, when plotted as a function of normalised lens radius, is a function of lens age and differs both between the equatorial and axial directions and between the anterior and posterior halves of the optical axis. The refractive index of the lens nucleus exhibits a significant reduction with age amounting to 3.4+/-0.6 x 10(-4) years(-1). The contribution of the gradient index (GRIN) to the lens power decreases by 0.286+/-0.067 D/year, accounting almost entirely for the estimated overall change in lens power with age for these lenses, which were probably in their most accommodated state. The results provide experimental verification of hypothesised changes in the GRIN that have previously been invoked as contributing to presbyopia and support the hypothesis that changes in the GRIN are sufficient to offset effects of increasing curvature of human lenses with age in their unaccommodated state.

Accommodation, Ocular↗
PubMed1987

[Possibilities and limits of marking the visual axis of the cornea using the surgical microscope].

In procedures involving refractive corneal surgery, as in the fitting of conventional optical devices for visual correction, the question of correct centering arises, i.e., the surgeon has to determine and mark the point of intersection of the visual axis on the cornea. The operating microscope, which is in any case used for the surgical procedure, provides the simple means of performing this task. The practical application of this procedure, the theory behind it, and suggestions as to possible instrumentation are the subject of this paper.

Cornea↗
PubMed2006

Diurnal fluctuations and developmental changes in ocular dimensions and optical aberrations in young chicks.

PURPOSE: To investigate further the emmetropization process in young chicks by studying the diurnal fluctuations and developmental changes in the ocular dimensions and optical aberrations, including refractive errors, of normal eyes and eyes that had the ciliary nerve sectioned (CNX). METHODS: The ocular dimensions and aberrations in both eyes of eight CNX (surgery on right eyes only) and eight normal chicks were measured with high-frequency A-scan ultrasonography and aberrometry, respectively, four times a day on five different days from posthatching day 13 to 35. A fixed pupil size of 2 mm was used to analyze aberration data. Repeated-measures ANOVA was applied to examine the effects of age, time of day, and surgery. RESULTS: Refractive errors and most higher-order aberrations decreased with development in both normal and CNX eyes. However, although normal eyes showed a positive shift in spherical aberration with age, changing from negative spherical aberration initially, CNX eyes consistently exhibited positive spherical aberration. Anterior chamber depth, lens thickness, vitreous chamber depth, and thus optical axial length all increased with development. Many of these ocular parameters also underwent diurnal changes, and mostly these dynamic characteristics showed no age dependency and no effect of CNX. Anterior chamber depth, vitreous chamber depth, and optical axial length were all greater in the evening than in the morning, whereas the choroids were thinner in the evening. Paradoxically, eyes were more hyperopic in the evening, when they were longest. Although CNX eyes, having enlarged pupils, were exposed to larger higher-order aberrations, their growth pattern was similar to that of normal eyes. CONCLUSIONS: Young chicks that are still emmetropizing, show significant diurnal fluctuations in ocular dimensions and some optical aberrations, superimposed on overall increases in the former and developmental decreases in the latter, even when accommodation is prevented. The possibility that these diurnal fluctuations are used to decode the eye's refractive error status for emmetropization warrants investigation. That eyes undergoing ciliary nerve section have more higher-order aberrations but do not become myopic implies a threshold for retinal image degradation below which the emmetropization process is not affected.

Animals↗
PubMed2006

Guiding light in optically induced ring lattices with a low-refractive-index core.

We demonstrate a ring-shaped Bessel-like photonic lattice akin to a photonic bandgap fiber with a low-index core. While the ring lattice is optically induced in a bulk crystal with a self-defocusing nonlinearity, guidance of a probe beam propagating linearly through the core is clearly observed. The possible mechanism for such guidance is also discussed.

Journal Article↗
PubMedDate not supplied

[From scattering to wavefront. Healing optics].

The purpose of this report, made within research in progress, was to discuss the optical effect of irregular surface structures that might be associated with complicated refractive procedures related with the retinal image quality. We concentrated our discussion on the range of surface structures between the known scattering effects and wavefront aberrations of higher orders. The case study demonstrates that the surface irregularities of the cornea might induce, after refractive laser surgery, significant optical aberrations that are much too different from the classical wavevront or scattering errors. Such optical errors, however, cannot be correctly measured by current commercial wavefront sensors. Finally, the influence of the healing process on Strehl ratio is under discussion.

Cornea↗
PubMed2005

Wave optics of Liesegang rings.

Liesegang rings refract and reflect at the interface between the regions of the same gel but of different thickness. The incident and the refracted rings obey a refraction law analogous to the Snell's law of classical optics, with a reverse of the spacing coefficient being a counterpart of the refraction index. The wavelike behavior of the rings at the interface is explained by geometrical arguments derived from the Jablczynski's spacing principle, and is reproduced in numerical simulations based on a three-dimensional minimalistic version of the nucleation-growth model.

Journal Article↗
PubMed2004

The ocular manifestations of Weissenbacher-Zweymuller syndrome.

PURPOSE: Weissenbacher-Zweymuller syndrome (WZS) is an autosomal recessive disorder of delayed skeletal maturation. Its characteristic features include rhizomelic dwarfism with metaphyseal and vertebral changes. It has been challenged whether WZS is a part of the spectrum of Stickler syndrome. We report ocular findings in the largest ever-presented series of patients with WZS. METHODS: Patients underwent a paediatric examination, including assessment of growth and development, genetic work-up and X-ray of vertebra and long bones. All had a complete ophthalmic examination, cycloplegic refraction, and face and body photography. RESULTS: All patients had hypertelorism and protruding eyes. Four patients had refractive errors necessitating optical correction ranging from +3 to -8 D. Two patients had strabismus. None had vitreoretinal degeneration, glaucoma, or cataract. CONCLUSIONS: Ocular manifestations of WZS differ from those in Stickler syndrome, indicating that the two likely represent distinct clinical entities. Strabismus and various refractive errors often accompany WZS. An ophthalmologist should follow children with this disorder from an early age to prevent amblyopia.

Adolescent↗
PubMed2005

Refractive status of indigenous people in the northwestern Amazon region of Brazil.

PURPOSE: The purpose of this study was to investigate the refractive status of the illiterate indigenous people of the upper Rio Negro region of the Amazon rain forest in northwestern Brazil. METHODS: From an overall sample of 486 people, 259 indigenous people and 78 Brazilians between 12 and 59 years of age with no compromising optical opacities were refracted with cycloplegic retinoscopy. Subjects were categorized as indigenous if they had at least three generations of indigenous ancestry with no folklore suggesting other ancestors. RESULTS: Myopia was rare among the indigenous population. Only 2.7% of eyes showed myopia of -1.00 D or more and 1.6% (four people) had bilateral myopia of -1.00 D or more. Half of this small group were the only educated indigenous people examined. The prevalence of astigmatism and anisometropia equal to or >1.00 D was 15.5% and 8.2%, respectively. Most of the astigmatism in the indigenous people had an against-the-rule axis. Age was not associated with the refractive errors of the indigenous people. Brazilians from the small city in which the study was performed had higher rates of myopia (6.4% of eyes and 5.1% of subjects bilaterally). Older preeducation adults also had a very low prevalence of myopia (3.2% of eyes and 2.0% of subjects), whereas the younger, slightly educated Brazilians had a higher prevalence of myopia (11.3% of eyes and 9.7% of subjects). CONCLUSION: The low prevalence of myopia in the illiterate indigenous people is consistent with other studies and suggests that myopia is related to literacy. The generational change among the local mixed race Brazilians further supports this conclusion. The relatively high rates of astigmatism and anisometropia in the indigenous people were unusual for a predominantly emmetropic sample.

Adolescent↗
PubMedDate not supplied

Are optical aberrations during accommodation a significant problem for refractive surgery?

PURPOSE: To study the limits to a perfect ideal customized wavefront correction due to the change of aberrations during accommodation. METHODS. We measured the dynamic changes of ocular aberrations during accommodation in normal eyes with a real-time Hartmann-Shack wavefront sensor. Those results were used in computer simulations to predict the benefit of a perfect customized correction. RESULTS: Due to the continuous changes of the aberrations over time, an ideal perfect static correction will not provide stable aberration-free optics. For example, when the eye accommodates to near objects, due to the changing aberrations, the eye will become aberrated again. An alternative correction using the aberration pattern for a slightly accommodated condition could provide a better-correction in a larger accommodative range, although at the cost of non-perfect correction for far vision. CONCLUSIONS: Due to the dynamic nature of ocular optics, a static perfect correction, for instance performed in customized refractive surgery, would not remain perfect for every condition occurring during normal accommodation.

Accommodation, Ocular↗