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PubMedDate not supplied

Relationship between axial length of the emmetropic eye and the age, body height, and body weight of schoolchildren.

This report assesses the relationship of axial length of emmetropic (without refractive error) eyes to age, height, and weight in 1,600 Croatian schoolchildren. Axial eye lengths were determined by an ultrasonic eye biometry (A scan). Axial length of both eyes increases with age, height, and weight but shows a closer correlation to height and weight than to age. Boys have a significantly longer axial eye length than girls (P < 0.01). Boys or girls of similar or nearing body height and body weight and with emmetropic eyes have close linear measures of anatomic eye structures within their sex, regardless their age. Body height demonstrates the closest correlation to the growth and development of the emmetropic eye.

Adolescent↗

PubMed2005

Fetal size charts for the Italian population. Normative curves of head, abdomen and long bones.

OBJECTIVE: To describe size charts developed from fetuses of Italian couples. METHOD: Prospective cross-sectional investigation conducted in three referral centers for prenatal diagnosis. The population of the study included fetuses between the 16th and the 40th week of gestation recruited prospectively and examined only once for the purpose of this study. Exclusion criteria comprised all maternal and/or fetal conditions possibly affecting fetal biometry. The following biometric variables were measured: biparietal diameter, head circumference, abdominal circumference, femur, tibia, humerus, ulna and radio length. The statistical procedure recommended for analyzing this type of data set was employed to derive normal ranges and percentiles. Birthweight was also recorded. Our centiles were then compared with results from other studies. RESULTS: The best-fitted regression model to describe the relationships between head circumference and abdominal circumference and gestational age was a cubic one, whereas a simple quadratic model fitted BPD, and length of long bones. Models fitting the SD were straight lines or quadratic curves. Neither the use of fractional polynomials (the greatest power of the polynomials being 3) nor the logarithmic transformation improved the fitting of the curves. CONCLUSION: We have established size charts for fetuses from Italian couples using the recommended statistical approach. Since the mean birthweight in this study is not statistically different from the official birthweight reported for the Italian population, these reference intervals, developed according to the currently approved statistical methodology, can be employed during second- and third-trimester obstetric ultrasound of fetuses from Italian couples.

Abdomen↗

PubMed1994

The biometric evaluation of the acute-toxic-class method (oral).

The acute toxic class method (ATC method) is an alternative to the LD50 test, with the use of substantially fewer animals needed for the classification of substances. Like the classical LD50 test the biometry of the ATC method is based on the probit model. The biometric calculations of the ATC method were carried out not only for the classification categories of the European Union but also for the classification criteria of various countries and organizations, currently in use. It is demonstrated that in comparison with the LD50 test in general the same classification is obtained with the ATC method and with the use of substantially fewer animals. Substances with high slopes are likely to be allocated to the predicted toxicity class in comparison with substances having low slopes, with both the ATC method and the LD50 test. Substances are more likely to be allocated into a lower toxicity class with the LD50 test than with the ATC method.

Animal Testing Alternatives↗

PubMed2005

[Biometrical methods for the proof of efficacy in regulatory submissions. Non-inferiority in clinical studies].

The increasing number of approved efficacious therapies for various indications raises the question of whether the inclusion of a placebo group is still justified. In addition, pharmaceutical companies and regulatory agencies acknowledge that it may be sufficient to prove that a new therapy is comparable to an approved reference therapy regarding efficacy and safety in some situations. This becomes especially striking for the approval to market a generic drug. Another, perhaps even more important example is the increasing resistance of bacteria which calls for new antibiotics based on new therapeutic principles without having the claim for better efficacy. In these situations, a comparable efficacy would constitute progress. In the present paper, we discuss the numerous methodological challenges and approaches to overcome these problems that occur when it is not possible or even not wanted to use the classic approach of a randomized placebo-controlled superiority trial. Here, the field of medical biometry, which has proved in the last 25 years to be an integral part of the development of new drugs, demonstrates its suitability as a flexible and scientifically based means to fulfil the requirements resulting from clinical practice. Starting from the fact that statistical methods are not able to prove "equality" of two treatments, "shifted" hypotheses are considered and their importance for the different study designs is discussed. We show how the classic hypotheses known from placebo-controlled clinical trials can be embedded in this concept. The implications of this approach for the analysis and interpretation of study results is further discussed. The relevant guidelines of the European and US regulatory agencies are taken into account.

Biometry↗

PubMed2003

Comparative histological and biometric study of the coronary, radial and left internal thoracic arteries.

In an attempt to elucidate the causes of occlusion of radial arteries used for coronary artery bypass grafts and to improve the results of these procedures, we studied the biometry and histology of the coronary, radial and left internal thoracic arteries. These arteries were harvested from 20 cadavers (13 males, 7 females). The specimens were calibrated to the various bypass graft sites using coronary calibrators, and were then submitted to histological examination to determine the structure and innervation of the vessel wall. No correlation was observed between the internal calibers of these various arteries, with the exception of the anterior interventricular and right coronary arteries. Intimal changes and the presence of atheromatous plaque were observed in coronary and radial arteries, but never in the internal thoracic artery. Like the coronary arteries and their branches, the radial artery is a muscular artery. Aging of muscular arteries results in thickening of the intima, which becomes fibrotic due to migration of myocytes from the media and duplication of the internal elastic lamina. The media becomes fibrous, hypertrophic or atrophic. The walls of the radial and coronary arteries contain several adventitial nerves (sympathetic and parasympathetic nerve fibers), but these nerve fibers were not observed in the wall of the left internal thoracic artery. In contrast, the internal thoracic artery, like the aorta, is an elastic artery. Aging of elastic arteries is first observed between the ages of 20 and 29 years and is characterized by loss of one or several elastic laminae of the media and more marked intimal thickening, over a variable length. Even if a radial artery's caliber is similar to that of the coronary artery, histological evolution and graft patency depend on its muscular identity.

Aged↗

PubMed2006

Anatomical basis for clamping of the right hepatic vein outside the liver during right hepatectomy.

The possibility and value of clamping the right hepatic vein (HV) outside the liver during right hepatectomy remain a matter of debate. We carried out an anatomical study on ten fresh cadaveric subjects with no abdominal scarring or hepatic lesions, to determine the biometry of the extraparenchymatous segment of the right HV. One or several accessory right HVs were found in 90% of cases on release of the right edge of the inferior vena cava (IVC). These accessory right HVs had a diameter greater than that of the superior right HV in 10% of cases. In 70% of cases, the extraparenchymatous segment of the vein was free of collateral branches, and in 30% of cases, it was joined by a branch close to its point of exit from the hepatic parenchyma. The length of the vein that can be clamped (length between the point of exit from the hepatic parenchyma and the point of entry of the right HV into the IVC) was 8.6 +/- 1.8 mm (6-12). The right HV entered the vena cava, at an acute angle, in 100% of cases. Clamping of the right HV was possible in all cases. Knowledge of these anatomical points makes it possible to isolate an extraparenchymatous segment of the right HV more safely. The right HV can be isolated and clamped outside the liver in more than 80% of cases, making it possible to carry out right hepatectomy on an exsanguinous liver.

Aged↗

PubMed2006

Performance enhancement for audio-visual speaker identification using dynamic facial muscle model.

Science of human identification using physiological characteristics or biometry has been of great concern in security systems. However, robust multimodal identification systems based on audio-visual information has not been thoroughly investigated yet. Therefore, the aim of this work to propose a model-based feature extraction method which employs physiological characteristics of facial muscles producing lip movements. This approach adopts the intrinsic properties of muscles such as viscosity, elasticity, and mass which are extracted from the dynamic lip model. These parameters are exclusively dependent on the neuro-muscular properties of speaker; consequently, imitation of valid speakers could be reduced to a large extent. These parameters are applied to a hidden Markov model (HMM) audio-visual identification system. In this work, a combination of audio and video features has been employed by adopting a multistream pseudo-synchronized HMM training method. Noise robust audio features such as Mel-frequency cepstral coefficients (MFCC), spectral subtraction (SS), and relative spectra perceptual linear prediction (J-RASTA-PLP) have been used to evaluate the performance of the multimodal system once efficient audio feature extraction methods have been utilized. The superior performance of the proposed system is demonstrated on a large multispeaker database of continuously spoken digits, along with a sentence that is phonetically rich. To evaluate the robustness of algorithms, some experiments were performed on genetically identical twins. Furthermore, changes in speaker voice were simulated with drug inhalation tests. In 3 dB signal to noise ratio (SNR), the dynamic muscle model improved the identification rate of the audio-visual system from 91 to 98%. Results on identical twins revealed that there was an apparent improvement on the performance for the dynamic muscle model-based system, in which the identification rate of the audio-visual system was enhanced from 87 to 96%.

Adult↗

PubMed1994

Variation in early fetal growth.

OBJECTIVE: To obtain more information on interindividual variation in early fetal growth by using early fetal ultrasound parameters. DESIGN AND SUBJECTS: Individual fetal growth was assessed prospectively in 109 pregnancies by serial ultrasound measurements of CRL and BPD. From the resulting biometry data, individual CRL and BPD growth curves for each fetus were constructed and compared. RESULTS: A high correlation was found between growth rate and the start of growth of CRL and BPD, r = 0.79 and r = 0.84, respectively. CONCLUSION: The high correlation between growth rate and the start of growth of CRL and BPD might imply that a fetus with an impeded start of growth generally has a higher growth rate. This could be called an early pregnancy 'catch-up growth'. This interindividual variation of starting time and fetal growth rate may influence the assessment of gestational age in early pregnancy, if a CRL-curve obtained from cross-sectional measurements is used as a reference. BPD seems to be a more constant parameter with less variation in growth rate.

Biometry↗

PubMed1993

The history of ultrasound techniques in ophthalmology.

The history of 50 years of applications of ultrasound in ophthalmology is described. This period started in 1938 with a study of the possible effects of high intensity ultrasound on eyes. The measurement of biological effects for the assessment of potential hazards characterizes the first decades. More recently, the therapeutic use of ultrasound by hyperthermia has gained much interest in ophthalmology. Further topics are: the measurement of acoustic characteristics of ocular tissues; the biometry of the eye ball, the results of which are used to calculate the optical power of artificial lens implants; the development of diagnostic instruments in various parts of the world; and ultrasonic tissue characterization for the differential diagnosis of pathology. The final topic is concerned with some recent developments which present a look into the future.

Biometry↗

PubMed1990

Effects of maternal cigarette smoking on ultrasonic measurements of fetal growth and on Doppler flow velocity waveforms.

Serial ultrasound biometry and Doppler flow velocity waveform analysis were used to measure the effects of maternal smoking in a prospective study of 535 pregnancies. Smoking was associated with significant reductions in maternal weight gain, birthweights and placental weights. Decreased fetal biparietal diameter measurements were observed in pregnancies of smoking women; this effect was maximal at 24 weeks' gestation, was restricted to male fetuses and was not associated with altered head circumferences after birth. Umbilical artery and uteroplacental systolic/diastolic ratios were similar in pregnancies of smoking and non-smoking women, indicating that the effects of smoking on placental vascular resistance are periodic rather than continuous. The findings of this study confirm the need for studies of fetal growth to include prenatal measurements obtained by high resolution ultrasound imaging, rather than relying on findings obtainable by examination of the infant after birth.

Adult↗

PubMed2005

Isoprostanes in amniotic fluid: a predictive marker for fetal growth restriction in pregnancy.

Isoprostanes are markers of free radical-catalyzed lipid peroxidation. Evidence suggests that oxidative stress occurs in pregnancies with fetal growth restriction (FGR). The aim of this study was to analyze F2-isoprostanes in amniotic fluid of FGR pregnancies. We tested the hypothesis that F2-isoprostanes are reliable markers to distinguish FGR pregnancies from normal ones and appropriate-for-gestational-age (AGA) from small-for-gestational-age (SGA) newborns. F2-isoprostanes levels were measured by colorimetric enzyme immunoassay in the amniotic fluid of 77 pregnancies with normal fetal growth (group I) and 37 with FGR (group II). Fetal biometry and Doppler measurements were obtained using an ATL HDI 3000 ultrasound system. Isoprostanes were higher in group II than group I. The ROC curve distinguished group I from group II, showing 100% sensitivity and 88.3% specificity at a cutoff of 94 pg/ml. There were no statistical differences in isoprostanes levels between AGA and SGA newborns in group II. The area under the ROC curve drawn to distinguish AGA and SGA newborns showed a sensitivity of 100% and a specificity of 72.3% at a cutoff of 94 pg/ml. The relative risk index indicated a 8.05 times higher risk of birth weight below the 3rd percentiles in group II than in group I. High isoprostanes concentrations can be detected in the amniotic fluid of FGR pregnancies and the assay of isoprostanes in amniotic fluid is a reliable assessment of fetal oxidative stress. Common use of this predictive marker in obstetrics will improve the ability of clinicians to identify those fetuses who will be born SGA or with a birth weight below the 25th percentile.

Adolescent↗

PubMed2006

Long-term refractive and biometric outcomes following diode laser therapy for retinopathy of prematurity.

PURPOSE: To assess the long-term refractive and biometric outcomes of diode laser-treated eyes in threshold retinopathy of prematurity (ROP). METHODS: Cycloplegic autorefraction and biometry (Zeiss IOLMaster) were performed, at a mean follow-up of 11 years, on 16 laser-treated eyes with threshold ROP and 9 comparison eyes with subthreshold untreated ROP. RESULTS: The laser-treated eyes had a mean spherical equivalent of -2.33 D with a mean astigmatic error of 1.38 D. The comparison eyes had a mean spherical equivalent of +1.07 D with a mean astigmatic error of 0.42 D. This trend toward increased myopia in treated eyes did not achieve statistical significance (p=0.08). The myopia in the laser group appeared to be slowly progressive in nature when compared with earlier refractive data for these patients. The laser-treated eyes had reduced anterior chamber depth (ACD) compared with the subthreshold eyes (p=0.02). When physiologic accommodation was inhibited by cycloplegic drops, the anterior chamber deepened by 0.13 mm in the laser-treated eyes and by 0.06 mm in the comparison eyes. This effect of accommodation on ACD did not differ significantly between the two groups (p=0.23). The laser-treated eyes and the comparison eyes did not differ significantly in terms of axial length, corneal power, corneal diameter, or lens power. However, both groups had steeper corneas, shallower anterior chambers, and shorter axial lengths when compared with historical full-term controls. CONCLUSIONS: Myopia in premature infants requiring laser treatment for ROP is associated with a shallowing of the anterior chamber and a steepening of the cornea. Physiological accommodation is not impaired by laser therapy or by severe ROP.

Accommodation, Ocular↗

PubMed2004

Analysis of nonlinear systems to estimate intraocular lens position after cataract surgery.

PURPOSE: To compare the performance of neural networks with that of linear regression to predict the postoperative effective lens position (ELP) from preoperative biometry measurements. SETTING: Departments of Ophthalmology, Medical Cybernetics and Artificial Intelligence, and Medical Physics, Medical University of Vienna, Vienna, Austria. METHODS: The neural-network-type multilayer perceptron (MLP) and a linear regression technique were used to predict ELP. Suitable MLP models and variable input combinations were selected by extended-feature subset selection. Apart from the usual preoperative biometric variables, anterior chamber depth and lens thickness were measured with partial coherence interferometry and white-to-white measurements were used as input variables. RESULTS: Prediction of ELP could be improved from a correlation coefficient (Pearson) of 0.54 for linear regression to a coefficient of 0.68 for the MLP; however, this difference was not statistically significant. CONCLUSION: The prediction of postoperative ACD with the MLP was not significantly better than the prediction using linear regression.

Adult↗

PubMed2004

Static and dynamic analysis of the anterior segment with optical coherence tomography.

PURPOSE: To study biometric modifications of the anterior segment with accommodation and age and determine possible applications in areas of anterior segment surgery, particularly implantation of refractive lenses. SETTING: Clinique Monticelli, Marseille, France. METHOD: The study comprised subjects between 7 years of age and 82 years of age in whom anterior chamber biometry was evaluated using 1,310 nm wavelength optical coherence tomography (OCT). The equipment has a fixation target that can be focused and defocused with negative lenses to stimulate natural accommodation. All measurements were performed by the same operator. The horizontal diameter of the AC, the anterior chamber depth (ACD), the horizontal pupil diameter, and the horizontal radius of curvature of the crystalline lens' anterior pole were measured in the unaccommodated state and after stimulating accommodation. RESULTS: Fifty-six subjects (104 eyes) were included; the refractions ranged from +5.0 diopters (D) to -5.0 D. The static and dynamic measurements were compared with ametropia, age, and accommodation. At rest, the mean AC diameter was 12.334 mm, the mean ACD was 3.106 mm, and the mean pupil diameter was 4.258 mm. With 1.0 D of accommodation, the anterior pole moved forward by a mean of 30 microm, the radius of curvature decreased 0.3 mm, and the pupil diameter decreased 0.15 mm. CONCLUSIONS: The AC OCT is a user-friendly instrument for evaluating the anterior segment and examining the AC (cornea, iris, crystalline lens, and iridocorneal angle). The 1,310 nm light wavelength is blocked by pigments, preventing examination behind the iris. However, the AC OCT is capable of good image quality and visualization of the anatomical relationships in the anterior segment, even behind an opaque cornea.

Accommodation, Ocular↗

PubMed2005

Capsular bag shrinkage after implantation of a capsular bending or capsular tension ring.

PURPOSE: To evaluate the influence of a capsular bending ring (CBR) or tension ring (CTR) on capsular bag shrinkage. SETTING: Department of Ophthalmology, Johannes Gutenberg-University, and Department of Medical Biometry, Epidemiology and Informatics, University of Mainz, Mainz, Germany. METHODS: In 92 eyes of 92 patients, a capsular measuring ring (CMR) was implanted after phacoemulsification to measure capsular bag size in vivo. Patients were randomized into 3 groups: The first received a CMR and CBR, the second received a CMR and CTR, and the third received a CMR alone. Measurements were performed preoperatively, intraoperatively, during the first 3 postoperative days, and after 1 and 3 months. Preoperative biometric characteristics such as axial length (AL) and anterior chamber depth were determined. Primary clinical end points were capsular bag size and capsulorhexis diameter measured intraoperatively and by means of slitlamp biomicroscopy and retroillumination photography postoperatively. RESULTS: There were no clinically relevant group differences in AL, anterior chamber depth, or capsulorhexis diameter. Eyes implanted with the CBR showed shrinkage of the capsular bag from 10.6 to 10.4 mm after a median of 3 months (sign test; P = .023); eyes with a CTR showed comparable median capsular bag shrinkage from 10.5 to 10.2 mm (P<.001), whereas eyes without a CTR showed a median shrinkage from 10.5 to 10.0 mm (P<.001). Intraindividual shrinkage was of a similar, although significantly different, order among these groups (median shrinkage 0.15 versus 0.23 and 0.38 mm, respectively; all pairwise Wilcoxon test; P = .050, P = .020, P<.001, respectively). CONCLUSIONS: Capsular shrinkage can be inhibited by a CBR and, to lesser extent, a CTR; the gain in shrinkage prevention is limited when compared with a CMR, however. This conclusion can be drawn only for the specific CBR or CTR and hydrophobic acrylic intraocular lens (IOL) used in this study. Reduction of capsular bag shrinkage after CTR implantation may reduce IOL dislocation and tilt and help to maintain postoperative visual acuity.

Adult↗

PubMed2006

Accuracy of intraocular lens power prediction using the Hoffer Q, Holladay 1, Holladay 2, and SRK/T formulas.

PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculations using 4 formulas: Hoffer Q, Holladay 1, Holladay 2, and SRK/T. SETTING: Tertiary care center. METHODS: This study was a retrospective comparative analysis. Immersion ultrasound biometry (axial length, anterior chamber depth, and lens thickness), manual keratometry, and postoperative manifest refraction were obtained in 643 eyes of consecutive patients who had routine uneventful cataract surgery with implantation of 1 of 2 IOLs using the same operative technique by the same surgeon. Biometric data were entered into each of the 4 IOL power calculation formulas, and the results were compared to the final manifest refraction. An optimized lens constant was used for each formula. Results were also stratified into groups of short, average, medium long, and very long axial length <22.0 mm, 22.0 to <24.5 mm, 24.5 to 26.0 mm, and >26.0 mm, respectively). RESULTS: No formula was more accurate than the others as measured by mean absolute error. The formulas were also equally accurate when eyes were stratified by axial length. CONCLUSION: The 4 IOL power formulas provided equivalent refractive results in the entire group of eyes and in the subsets of axial lengths tested.

Biometry↗

PubMed2005

Anterior chamber width measurement by high-speed optical coherence tomography.

OBJECTIVE: To measure anterior chamber (AC) width and other dimensions relevant to the sizing of phakic intraocular lenses (IOLs) with a high-speed optical coherence tomography (OCT) system. DESIGN: Cross-sectional observational study. PARTICIPANTS: Both eyes of 20 normal volunteers. METHODS: A novel high-speed (4000 axial scans/second) OCT prototype was developed for anterior segment scanning. The system uses long wavelength (1310 nm) for deeper angle penetration, rectangular scanning for undistorted imaging, and short image acquisition time (0.125 seconds) to reduce motion error. Three horizontal cross-sectional OCT images (15.5 mm wide and 6 mm deep) of the anterior segment were obtained from each eye with real-time image display to guide centration on the corneal apex. Image processing software was developed to correct for image warping resulting from index transitions. Anterior chamber dimensions were measured using computer calipers by 3 expert raters (ophthalmologists). Analysis of variance was used to determine interrater, interimage, right versus left eye, and intersubject standard deviation (SD) of OCT measurements. MAIN OUTCOME MEASURES: Anterior chamber width (recess to recess), AC depth, and crystalline lens vault as measured by OCT; external white-to-white (WTW) corneal diameter (CD) as measured by Holladay-Godwin gauge. RESULTS: The mean AC width was 12.53+/-0.47 mm (intereye SD), and the mean corneal diameter was 11.78+/-0.57 mm. Optical coherence tomography measurement of AC width has good repeatability from image to image (SD, 0.134 mm), but there was significant difference between raters (SD, 0.215 mm). Estimation of AC width from WTW CD by linear regression was relatively inaccurate (residual SD, 0.41 mm). The mean AC depth was 2.99+/-0.323 mm (intereye SD), with repeatability of less than 0.001 mm (interimage SD), and the mean crystalline lens vault was 0.39+/-0.27 mm with 0.023 mm repeatability. CONCLUSIONS: Reproducible OCT AC biometry was demonstrated using a high-speed OCT prototype. Further improvement in reproducibility may be achieved by automating the measurements with a computer. Direct OCT AC width measurement may improve sizing of angle-supported AC IOLs over conventional estimation by WTW CD. The measurement of AC depth and lens vault also may be useful for other types of phakic AC IOLs.

Adult↗

PubMed2005

Stimulus-driven versus pilocarpine-induced biometric changes in pseudophakic eyes.

PURPOSE: Most trials that study the lens movement of accommodative intraocular lens (IOLs) use pilocarpine to stimulate ciliary muscle contraction. The aim of this study is to assess in vivo whether a more physiologic, stimulus-driven accommodation is comparable to pilocarpine-induced IOL movement. DESIGN: Controlled patient- and examiner-masked clinical trial. PARTICIPANTS: The study population included 38 eyes with accommodative IOL implants (1CU) and a control group of 28 eyes with conventional open-loop IOLs. METHODS: A high-precision biometry technique, partial coherence interferometry, was used to measure IOL position. Anterior chamber depth was measured during physiologic (near point) and pharmacological (pilocarpine 2%) stimulation. In a subgroup of 14 1CU eyes, IOL position was determined repeatedly within 90 minutes after pilocarpine administration. A different subgroup was investigated as to the effect of cyclopentolate on IOL position. Best-corrected distance visual acuity (VA), best-corrected near VA, and distance-corrected near VA (DCNVA) were assessed using logarithm of the minimum angle of resolution charts. MAIN OUTCOME MEASURES: Anterior chamber depth change under pilocarpine and near-point-driven accommodation. RESULTS: Near-point accommodation did not induce movement of either the accommodating 1CU or the control IOLs. Pilocarpine induced a 201+/-0.137-mm anterior movement of the 1CU IOL (P<0.001), compared with no movement within the control IOL groups (P>0.05). There was no significant (P>0.05) difference in DCNVA between the accommodative and open-loop IOLs. No correlation between near point- or pilocarpine-stimulated IOL movement and DCNVA was found. Concerning the time course of movement after pilocarpine administration, most of the 1CU IOLs showed some movement 30 minutes after application. Cyclopentolate-induced ciliary muscle relaxation caused a posterior IOL movement, as compared with the relaxed state, when focusing on a distant target. CONCLUSION: Pilocarpine-induced ciliary muscle contraction seems to overestimate IOL movement relative to a monocular near-driven stimulus. Therefore, concerning IOL movement, pilocarpine may act as a superstimulus and may not adequately simulate daily life performance of accommodative IOLs. However, it may be helpful to evaluate the maximum potential of an accommodating IOL.

Accommodation, Ocular↗