Visual simulation of intraocular lenses: from on-bench performance to computational and experimental validations.

This study presents a systematic method to simulate various intraocular lenses (IOLs) available in the market. Five IOLs (two trifocals, one bifocal, one enhanced monofocal, and one extended depth of focus (EDOF)) were evaluated in terms of through focus visual Strehl (TFVS) utilizing the OptiSpheric IOL PRO2 device (Trioptics GmbH). Then, the estimated TFVS (ETFVS) and the temporal coefficients necessary for temporal multiplexing were computed, and through an iterative process, the SimVis TFVS was obtained.

Simulation of daily soft multifocal contact lenses using SimVis Gekko: from in-vitro and computational characterization to clinical validation.

Multifocal contact lenses (MCLs) are one of the solutions to correct presbyopia, but their adoption is not widespread. To address this situation, visual simulators can be used to refine the adaptation process. This study aims to obtain accurate simulations for a visual simulator (SimVis Gekko; 2EyesVision) of daily soft MCL designs from four manufacturers.

Spatiotemporal defocus sensitivity function of the human visual system.

Tunable lenses make it possible to measure visual sensitivity to rapid changes in optical power, surpassing the limits imposed by mechanical elements. Using a tunable lens system, we measured, for the first time, the spatiotemporal defocus sensitivity function (STDSF), and the limits of human defocus perception. Specifically, we measured defocus sensitivity using a QUEST adaptive psychophysical procedure for different stimuli (Gabor patches of different spatial frequencies, natural images, and edges) and we developed descriptive models of defocus perception.

Defocus flicker of chromatic stimuli deactivates accommodation.

Tunable lenses, optical elements able to change their optical power within milliseconds, constitute an emerging technology increasingly used in ophthalmic applications. In this study, 25 subjects looked through tunable lenses at a chromatic stimulus to evaluate the perceptual response of the human visual system to periodic changes in defocus of 0.25D of amplitude and 15 Hz of temporal frequency.

Case report of the evidence of a spontaneous Reverse Pulfrich effect in monovision after cataract surgery.

Background: Cataracts affect the optics of the eye in terms of absorption, blur, and scattering. When cataracts are unilateral, they cause differences between the eyes that can produce visual discomfort and harm binocular vision. These interocular differences can also induce differences in the processing speed of the eyes that may cause a spontaneous Pulfrich effect, a visual illusion provoking important depth misperceptions.

Monovision Correction Preference and Eye Dominance Measurements.

Purpose: To propose new methods for eye selection in presbyopic monovision corrections.

Methods: Twenty subjects with presbyopia performed two standard methods of binary eye dominance identification (sensory with +1.50 diopters [D ]and +0.

Experimental characterization, modelling and compensation of temperature effects in optotunable lenses.

Most tunable lenses (TLs) are affected by deviations in optical power induced by external temperature changes or due to internal heating while in use. This study proposes: (1) An experimental characterization method to evaluate the magnitude of the optical power deviations due to internal temperature shifts; (2) three different mathematical models (experimental, polynomial, and optimized) to describe the response of the lens with temperature; (3) predictions of the internal temperature shifts while using the lens in time frames of minutes, seconds, and milliseconds and; (4) a real time optical power compensation tool based on the implementation of the models on a custom voltage electronic driver. The compensation methods were successfully applied to two TL samples in static and dynamic experiments and in hysteresis cycles.

Closed-loop experimental optimization of tunable lenses.

Tunable lenses (TLs) are optical devices that can change their optical power in response to an electrical signal. In many applications, they are often pushed to or beyond their temporal limits. Fast periodic and/or abrupt variations of the optical power induce undesired distortions in their transient response and produce a decrease in their performance.

Visual simulations of presbyopic corrections through cataract opacification.

Purpose: To study the viability of visual simulation of presbyopic correction in patients with cataract and the effect and impact of the cataract on the perceived visual quality of the different simulated presbyopic corrections preoperatively and postoperatively.

Setting: San Carlos Clinical Hospital, Madrid, Spain.

Design: Observational, noninterventional, pilot study, early feasibility of the device being studied.

Multifocal contact lens vision simulated with a clinical binocular simulator.

Purpose: The purpose of this study is to compare the binocular visual perception of participants wearing multifocal contact lenses and these same lens designs viewed through a temporal multiplexing visual simulator.

Methods: Visual performance and perceived visual quality at various distances were obtained in 37 participants wearing soft M-CLs and through the SimVis Gekko programmed with the same lenses. In a pilot study (n = 10) visual performance was measured in terms of LogMAR visual acuity (VA) at far (4 m), intermediate (64 cm) and near (40 cm) distances and through-focus VA (TFVA) curves with the simulated M-CLs.

Beyond traditional subjective refraction.

Purpose Of Review: The evaluation of refractive error is probably the most important and common procedure in eye care. The gold standard method for evaluating refractive error is subjective refraction, a process that has not significantly changed in 200years. This article aims to review recent technologies and novel approaches attempting to improve this traditional procedure.

Optical and visual quality of real intraocular lenses physically projected on the patient's eye.

Visual simulators aim at evaluating vision with ophthalmic corrections prior to prescription or implantation of intraocular lenses (IOLs) in the patient's eye. In the present study, we present the design, implementation, and validation of a new IOL-in-cuvette channel in an Adaptive Optics visual simulator, which provides an alternative channel for pre-operative simulation of vision with IOLs. The IOL is projected on the pupil's plane of the subject by using a Rassow system.

Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology.

As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations.

Multifocal acceptance score to evaluate vision: MAS-2EV.

We present a new metric (Multifocal Acceptance Score, MAS-2EV) to evaluate vision with presbyopic corrections. The MAS-2EV is based on a set of images representing natural visual scenes at day and night conditions projected in far and near displays, and a near stereo target. Subjects view and score the images through different binocular corrections (monofocal corrections at far; bifocal corrections; monovision and modified monovision) administered with soft contact lenses (in cyclopleged young subjects) or with a binocular simultaneous vision simulator (in presbyopic and cyclopleged young subjects).

Vision is protected against blue defocus.

Due to chromatic aberration, blue images are defocused when the eye is focused to the middle of the visible spectrum, yet we normally are not aware of chromatic blur. The eye suffers from monochromatic aberrations which degrade the optical quality of all images projected on the retina. The combination of monochromatic and chromatic aberrations is not additive and these aberrations may interact to improve image quality.

Longitudinal Chromatic Aberration in Patients Implanted With Trifocal Diffractive Hydrophobic IOLs.

Purpose: To measure the in vivo longitudinal chromatic aberration (LCA) from the chromatic difference of focus (480 to 700 nm) using psychophysical methods in patients bilaterally implanted with a hydrophobic trifocal intraocular lens (IOL).

Methods: Psychophysical best focus was measured in both eyes at different wavelengths (480 to 700 nm) and at three different viewing distances (0.00, +1.

Optical and Visual Quality With Physical and Visually Simulated Presbyopic Multifocal Contact Lenses.

Purpose: As multifocal contact lenses (MCLs) expand as a solution for presbyopia correction, a better understanding of their optical and visual performance becomes essential. Also, providing subjects with the experience of multifocal vision before contact lens fitting becomes critical, both to systematically test different multifocal designs and to optimize selection in the clinic. In this study, we evaluated the ability of a simultaneous vision visual simulator (SimVis) to represent MCLs.

Contact lenses, the reverse Pulfrich effect, and anti-Pulfrich monovision corrections.

Interocular differences in image blur can cause processing speed differences that lead to dramatic misperceptions of the distance and three-dimensional direction of moving objects. This recently discovered illusion-the reverse Pulfrich effect-is caused by optical conditions induced by monovision, a common correction for presbyopia. Fortunately, anti-Pulfrich monovision corrections, which darken the blurring lens, can eliminate the illusion for many viewing conditions.

Testing the effect of ocular aberrations in the perceived transverse chromatic aberration.

We have measured the ocular transverse chromatic aberration (TCA) in 11 subjects using 2D-two-color Vernier alignment, for two pupil diameters, in a polychromatic adaptive optics (AO) system. TCA measurements were performed for two pupil diameters: for a small pupil (2-mm), referred to as 'optical TCA' (oTCA), and for a large pupil (6-mm), referred to 'perceived TCA' (pTCA). Also, the TCA was measured through both natural aberrations (HOAs) and AO-corrected aberrations.

Pre-operative simulation of post-operative multifocal vision.

While multifocal intraocular lenses (MIOLs) are increasingly implanted to correct for presbyopia, how one sees with a multifocal correction is hard to explain and imagine. The current study evaluates the quality of various visual simulating technologies by comparing vision with simulated MIOLs pre-operatively and the implanted MIOLs post-operatively in the same patients. Two simulation platforms were used: (1) a custom-developed adaptiveoptics (AO) system, with two visual simulator devices: a spatial light modulator (SLM) and an optotunable lens operating under temporal multiplexing (SimVis); and (2) a wearable, binocular, large field of view SimVis2Eyes clinical simulator (SimVis Gekko, 2Eyes Vision, Madrid, Spain).

Perceptual impact of astigmatism induction in presbyopes.

We investigated the effect of induced astigmatism on subjective best focus and on visual acuity in 28 subjects of different ages (pre-presbyopic and presbyopic) and with different refractive profiles (emmetropes and astigmats). Measurements were performed using a custom-developed Adaptive Optics system, which allowed correction of high order aberrations and induction of astigmatism (0.5, 1, 1.

Vision with different presbyopia corrections simulated with a portable binocular visual simulator.

Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye).

Monovision and the Misperception of Motion.

Monovision is a common prescription lens correction for presbyopia [1]. Each eye is corrected for a different distance, causing one image to be blurrier than the other. Millions of people have monovision corrections, but little is known about how interocular blur differences affect motion perception.

Experimental validations of a tunable-lens-based visual demonstrator of multifocal corrections.

The Simultaneous Vision simulator (SimVis) is a visual demonstrator of multifocal lens designs for prospective intraocular lens replacement surgery patients and contact lens wearers. This programmable device employs a fast tunable lens and works on the principle of temporal multiplexing. The SimVis input signal is tailored to mimic the optical quality of the multifocal lens using the theoretical SimVis temporal profile, which is evaluated from the through-focus Visual Strehl ratio metric of the multifocal lens.

Visual simulators replicate vision with multifocal lenses.

Adaptive optics (AO) visual simulators based on deformable mirrors, spatial light modulators or optotunable lenses are increasingly used to simulate vision through different multifocal lens designs. However, the correspondence of this simulation with that obtained through real intraocular lenses (IOLs) tested on the same eyes has not been, to our knowledge, demonstrated. We compare through-focus (TF) optical and visual quality produced by real multifocal IOLs (M-IOLs) -bifocal refractive and trifocal diffractive- projected on the subiect's eye with those same designs simulated with a spatial light modulator (SLM) or an optotunable lens working in temporal multiplexing mode (SimVis technology).