Search

Purpose To investigate early changes in the disk halo under different light conditions after myopic small incision lenticule extraction (SMILE). Methods This prospective study included 70 eyes of 70 myopic patients aged 18–33 years, with a spherical equivalent (SE) of −5.87 ± 1.86 D, who underwent SMILE. The subjective refraction, higher-order aberrations (HOAs), pupillometry, and halo were measured preoperatively and postoperatively to analyse disk halo variations and correlated factors. Results At 5 cd/m2 and 1 cd/m2 luminance, the halo radius in the high myopia (HM) group reached a postoperative peak after 1 week ( p = 0.000 and 0.019, respectively), and recovered to baseline after 3 months. In the low-to-moderate (LM) myopia group, the halo radius did not differ 1 week postoperatively compared to the preoperative level ( p = 0.015), but significantly improved after 3 months ( p = 0.000). The halo radius correlated with SE, uncorrected distance visual acuity (UDVA), ocular HOAs, coma, and the pupillary light reflex in the LM group at all time points, but there were no correlations in the HM group. Conclusions Halo symptoms occurred early after SMILE, but recovered within 3 months. The recovery process was slower in the HM group than in the LM group, and the halo radius correlated with SE, UDVA, ocular HOAs, coma, and the pupillary light reflex.

To characterize quick contrast sensitivity function (qCSF) in keratoconus and its correlation with corneal topographic parameters.Patients with keratoconus (n = 120) who visited the Fudan Eye and ENT Hospital between April and June 2021 were enrolled in our study. A total of 215 eyes were subdivided into three groups according to maximum keratometry (KSignificant differences in the area under the log CSF (AULCSF) and CSF Acuity among the three groups were found, which decreased with an increase in KThe use of qCSF test can serve as a feasible tool to evaluate visual quality and severity of keratoconus, since changes in CS significantly correlated with keratoconus severity.

Object: To discuss the application and effect evaluation of glasses-free 3D technology in ICL surgery teaching. Methods: 10 ophthalmologists with no experience in (implantable collamer lens) ICL surgery were selected to randomly watch the videos of 10 cases of ICL surgery on a 2D traditional screen and 10 cases on a glasses-free 3D screen, respectively, and complete the questionnaire on the learning experience after watching. The learning experience includes the incision making process, anterior chamber changes during viscoelastic injection and removal, the lens position judgment after the injection, the adjustment of the lens loop process, the overall three-dimensionality of the surgery, and the situation of dizziness. Results: The glasses-free 3D group showed better learning experience (PConclusions: The glasses-free 3D display videos are more conducive for ophthalmologists to learn the key steps of ICL surgery, but it is still prone to dizziness.

Purpose This study is to investigate the contrast sensitivity function (CSF) using the quick CSF (qCSF) test in Chinese adults with myopia. Methods This case series study included 320 myopic eyes of 160 patients (mean age 27.75 ± 5.99 years) who underwent a qCSF test for acuity, area under log CSF (AULCSF), and mean contrast sensitivity (CS) at 1.0, 1.5, 3.0, 6.0, 12.0, and 18.0 cycle per degree (cpd). Spherical equivalent, corrected-distant visual acuity (CDVA), and pupil size were recorded. Results The spherical equivalent, CDVA (LogMAR), spherical refraction, cylindrical refraction, and the scotopic pupil size of the included eyes were − 6.30 ± 2.27 D (− 14.25 to − 0.88 D), 0 ± 0.02, − 5.74 ± 2.18 D, − 1.11 ± 0.86 D, and 6.77 ± 0.73 mm, respectively. The AULCSF and CSF acuity were 1.01 ± 0.21 and 18.45 ± 5.39 cpd, respectively. The mean CS (log units) at six different spatial frequencies were 1.25 ± 0.14, 1.29 ± 0.14, 1.25 ± 0.14, 0.98 ± 0.26, 0.45 ± 0.28, and 0.13 ± 0.17, respectively. A mixed effect model showed significant correlations between age and acuity, AULCSF, and CSF at 1.0, 12.0, and 18.0 cpd. Interocular CSF differences were correlated with the interocular difference of spherical equivalent, spherical refraction (at 1.0 cpd, 1.5 cpd), and cylindrical refraction (at 12.0 cpd, 18.0 cpd). The lower cylindrical refraction eye had higher CSF compared with the higher cylindrical refraction eye (0.48 ± 0.29 vs. 0.42 ± 0.27 at 12.0 cpd and 0.15 ± 0.19 vs. 0.12 ± 0.15 at 18.0 cpd). Conclusions The age-related decrease in contrast sensitivity is at low and high spatial frequencies. Higher-degree myopia may show a decrease in CSF acuity. Low astigmatism was noted to affect the contrast sensitivity significantly.

Introduction To investigate nighttime symptoms in patients with myopic anisometropia after monocular small incision lenticule extraction (SMILE) surgery. Methods Thirty-six patients who had undergone monocular SMILE more than 6 months previously were recruited at the Eye & ENT Hospital of Fudan University. The average age at surgery was 25.4 ± 6.1 years. Preoperative spherical equivalent (SE) was −3.77 ± 1.56 D in SMILE-treated eyes and −0.08 ± 0.66 D in unoperated eyes. Main measurements included uncorrected and corrected distance visual acuity, manifest refraction, halo radius, contrast sensitivity, nighttime symptoms, and patient satisfaction. Results The mean follow-up time was 13.9 ± 3.4 months. The efficacy and safety indexes were 1.18 and 1.28, respectively. The halo radius was not significantly different between SMILE-treated and unoperated eyes under luminance conditions of 1, 5, and 100 cd/m2 (P = 0.055). No significant differences were observed in contrast sensitivity at all spatial frequencies between eyes under both uncorrected and corrected conditions (all P > 0.05). None of the patients reported moderate or severe symptoms at night. Mild symptoms (glare, halo, starburst) were reported and binocularly equal in 13 patients, whereas four patients reported better night vision in SMILE-treated eyes than unoperated eyes, and one of them experienced mild night vision disturbance. The overall satisfaction score was 9.39 ± 0.80. Conclusions The disk halo size and contrast sensitivity in SMILE-treated eyes were similar to those in unoperated eyes, and nighttime symptoms almost completely resolved after SMILE.

Purpose. To compare the corneal biomechanical properties between post-LASIK ectasia and primary keratoconus. Methods. A total of 42 eyes of 42 patients with matching age and central corneal thickness (CCT) were divided into two groups according to diagnosis of post-LASIK ectasia (PLE group; n = 21; age range: 22–47 years) and primary keratoconus (KC group; n = 21; age range: 21–47 years). The corneal biomechanical properties were assessed using Scheimpflug-based technology (Corvis ST; Oculus Optikgeräte, Wetzlar, Germany). The paired t-test and linear regression analysis were performed. Results. The PLE group had significantly higher mean stiffness parameter at the first applanation (SP-A1; 76.65 ± 21.66 vs 52.72 ± 13.65, p ≤ 0.001 ) and mean stress-strain index (SSI) (SSI: 0.78 ± 0.16 versus 0.64 ± 0.12, p = 0.001 ) than the KC group. SP-A1 was positively correlated with CCT in the PLE group (Pearson’s r = 0.816, p ≤ 0.001 ), but not in the KC group (Pearson’s r = −0.014, p = 0.952 ). No statistical correlation was observed between SSI and CCT in either group (Pearson’s r = 0.292, p = 0.199 , and Pearson’s r = 0.004, p = 0.985 , respectively). Conclusions. In our case series, KC manifested more severe than PLE in biomechanical properties. Since SSI measurements were independent of corneal thickness, it can be used for corneal biomechanical assessment.

To investigate the clinical outcomes in small incision lenticule extraction (SMILE) and EVO implantable Collamer lens (ICL)-treated high myopia.Thirty-three SMILE-treated and 32 EVO ICL-treated patients were included and followed up for 6 months. Subjective refraction, contrast sensitivity, and disk halo size were measured preoperatively and postoperatively. Patient-reported outcomes (PROs) were obtained at the final visit.Significant differences in efficacy and safety indices were observed between the SMILE and EVO ICL groups at 6 months postoperatively (P0.05). In the SMILE group, the mesopic contrast sensitivity at 2.2 cycles per degree (cpd) and photopic contrast sensitivity at 0.5, 3.4, and 7.1 cpd were significantly improved. In the EVO ICL group, the mesopic contrast sensitivity at 7.1 cpd and photopic contrast sensitivity at 0.5, 7.1, and 14.6 cpd were significantly improved. The halo radii after SMILE were significantly increased at 1 week, showed a decreasing trend at 1 month, returned to baseline at 3 months, and progressed stably at 6 months. However, it was unchanged in the EVO ICL group. Regarding subjective experience, haloes were the most common disturbance with mild and little bothersomeness after EVO ICL in contrast to starbursts after SMILE.EVO ICL implantation yielded better visual outcomes, improved contrast sensitivity particularly at high spatial frequencies, had a stabler disk halo size, and increased incidence of haloes, with less influence than that of SMILE.The disk halo and PRO findings will be of benefit for consultations and evaluations in visual performance and disturbances.

The gold standard of a successful amblyopia treatment is full recovery of visual acuity (VA) in the amblyopic eye, but there has been no systematic study on both monocular and binocular visual functions. In this research, we aimed to quantify visual qualities with a variety of perceptual tasks in subjects with treated amblyopia. We found near stereoacuity and pAE dominance in binocular rivalry in “treated” amblyopia were largely comparable to those of normal subjects. CSF of the pAE remained deficient in high spatial frequencies. The binocular contrast summation ratio is significantly lower than normal standard. The interocular balance point is 34%, indicating that contrast in pAE is much less effective as the same contrast in pFE in binocular phase combination. Although VA, stereoacuity and binocular rivalry at low spatial frequency in treated amblyopes were normal or nearly normal, the pAE remained “lazy” in high frequency domain, binocular contrast summation, and interocular phase combination. Our results suggest that structured monocular and binocular training are necessary to fully recover deficient functions in amblyopia.

PURPOSE: It’s been shown that intensive monocular perceptual learning can improve visual acuity, contrast sensitivity, and vernier acuity in the amblyopic eye in adults with amblyopia. It is however not clear how much monocular training can enhance binocular visual functions. In the current study, we aimed to evaluate effects of monocular training on a variety of binocular functions. METHODS: Nineteen anisometropic amblyopes (18.5±1.26 yrs) were trained in a grating contrast detection task near each individual’s cutoff spatial frequency for 6 to 10 days (630 trials/day). Visual acuity, stereoacuity, monocular and binocular contrast sensitivity functions (CSF), binocular phase combination and binocular rivalry were tested before and after training. RESULTS: Training substantially improved contrast sensitivity at the trained spatial frequency (by 67.8%) and a wide range of untrained spatial frequencies (84.0% on average), logMAR acuity (from 0.51 to 0.34; about 2 lines) in the amblyopic eye, and stereoacuity from 929.1” to 80.4”. Training also significantly improved the dominance duration of the amblyopic eye (from 9% to 15%) in binocular rivalry through elongation of each dominant phase without changing switching frequency between the two eyes. On the other hand, training didn’t significantly improve the ratio of the areas under CSF between binocular and monocular (fellow eye) viewing (1.16 vs 1.11, p>0.1) and the interocular balance point, i.e. the contrast ratio at which the two eyes contribute equally to binocular phase combination (0.14 vs 0.16, p>0.10). There was no significant correlation between improvements in visual acuity, stereoacuity, and binocular rivalry. CONCLUSIONS: Although monocular training can improve visual acuity and contrast sensitivity and eye dominance of the amblyopic eye, the magnitudes of improvements didn’t correlate with each other; the impact of monocular training on binocular phase combination was not significant. The results strongly suggest that structured monocular and binocular training is needed to fully recover deficient visual functions in anisometropic amblyopia.

Visual performance is jointly determined by the quality of optical transmission of the eye and neural processing in the visual system. An open question is: Can effects of optical defects be compensated by perceptual learning in neural processing? To address this question, we conducted a perceptual learning study on 23 observers with myopic vision, targeting high frequency deficits by training them in a monocular grating detection task in the non-dominant eye near their individual cutoff spatial frequencies. The contrast sensitivity function and visual acuity in both eyes (without optical correction) were assessed for all the observers in the training group before and after training, and for all the observers in the control group twice with a 10-day interval between the tests. In addition, the threshold versus external noise contrast function was measured for five observers in the training group before and after training. We found that (a) training significantly improved contrast sensitivity at the trained spatial frequency, visual acuity, and contrast sensitivity over a wide range of spatial frequencies in both eyes; (b) training did not lead to any significant refractive changes; (c) the mechanism of improvements was a combination of internal additive noise reduction and external noise exclusion; and (d) the improvements in visual acuity and contrast sensitivity were almost fully retained for at least four months in the three observers tested. These results suggest that perceptual learning may provide a potential noninvasive procedure to compensate for optical defects in mild to modest myopia.