Relation between injected volume and optical parameters in refilled isolated porcine lenses

PURPOSE: This study was performed to elucidate the correlation between added lens refill material and enhanced lens power as well as the correlation between lens refilling volume and accommodative amplitude as determined by equatorial stretching of ex vivo refilled pigs' lenses. METHODS: Nine porcine lenses were refilled with increasing amounts of silicone oil. After each refill step, the lens power, the lens power change, and the lens thickness were measured both in the relaxed state and with a 3-mm larger ciliary body diameter. In addition, the spherical aberration of the refilled lenses was also quantified. RESULTS: Injection of 0.04 mL silicone material into the relaxed lens enhanced the lens power by 1 D. A 0.54-mm increase of the lens thickness in relaxed lenses added 1 D to the lens power. Increasing the lens refilling volume decreased the lens power changes measured at 3-mm ciliary body stretch. Spherical aberration was positive in the refilled lenses and increased with increasing lens refilling volume. CONCLUSION: The correlation found between the refilling volume and the lens power (0.04 mL D(-1)), as well as the correlation between the lens thickness and the lens power (0.54 mm D(-1)), might be important factors to be controlled in conjunction with surgery, as these also determine the lens power in the presence of this refill material. An increasing lens filling volume is associated with decreasing accommodative amplitude. The positive spherical aberration of refilled porcine lenses presents a sharp contrast to the negative aberration of natural pigs' lenses. Different lens contours and the transition from a gradient to a homogeneous refractive index might be responsible for this change in spherical aberration.     

Polymer refilling of presbyopic human lenses in vitro restores the ability to undergo accommodative changes

PURPOSE: Because presbyopia is thought to be accompanied by increased lens sclerosis this study was conducted to investigate whether refilling the capsule of the presbyopic human lens with a soft polymer would restore the ability of the lens to undergo accommodative changes. METHODS: Accommodative forces were applied to natural and refilled lenses by circumferential stretching through the ciliary body and zonular complex. Nine natural lenses and 10 refilled lenses from donors ranging in age from 17 to 60 years were studied. Two refill polymers with a different Young's modulus were used. The lens power was measured by a scanning laser ray-tracing technique, and lens diameter and lens thickness were measured simultaneously while the tension on the zonules was increased stepwise by outward pull on the ciliary body. RESULTS: In the natural lenses the older lenses were not able to undergo power changes with stretching of the ciliary body, whereas in the refilled lenses, all lenses showed power changes comparable to young, natural lenses. The refilled human lenses had a higher lens power than the age-matched natural lenses. The Young's modulus of the polymers influenced the lens power change when measured with the ciliary body diameter increased by 4 mm. CONCLUSIONS: Refilling presbyopic lenses with a soft polymer enabled restoration of lens power changes with mechanical stretching. Because sclerosis of the lens is an important factor in human presbyopia, refilling the lens during lens surgery for cataract could enable restoration of clear vision and accommodation in human presbyopia.     

Effect of infusion bottle height on lens power after lens refilling with and without a plug

PURPOSE: To evaluate the influence of intraoperative infusion bottle height on the power of refilled pig lenses. SETTING: Research Laboratory, Pharmacia Intraocular Lens Manufacturing Plant, Groningen, The Netherlands. METHODS: This study comprised 2 groups of pig eyes. In 1 group, the lens was refilled with silicone oil using a plug to close the capsulorhexis; in the other group, no plug was used. The anterior chamber depth, lens thickness, and vitreous chamber depth were measured by A-scan ultrasound. The total refraction was measured with a Hartinger refractometer. Measurements were performed with the infusion bottle at 0 cm, 25 cm, 50 cm, 75 cm, and 100 cm above eye level. Calculations using a model eye were performed to evaluate the change in lens power based on empirical data. RESULTS: The mean change in the power of refilled lenses caused by varying the height of the infusion bottle was 1.8 diopters. Lenses refilled with a plug had a thickness similar to that of natural lenses. Lenses refilled without a plug were significantly thinner (P<.05). The power of lenses refilled with a plug was significantly higher that of lenses refilled without a plug (P<.05). CONCLUSIONS: During lens refilling, infusion bottle height influenced the resulting lens power. Using a plug to close the capsulorhexis resulted in refilled lens dimensions similar to those of the natural lens.     

On- and off-eye spherical aberration of soft contact lenses and consequent changes of effective lens power.

BACKGROUND: Soft contact lenses produce a significant level of spherical aberration affecting their power on-eye. A simple model assuming that a thin soft contact lens aligns to the cornea predicts that these effects are similar on-eye and off-eye. METHODS: The wavefront aberration for 17 eyes and 33 soft contact lenses on-eye was measured with a Shack-Hartmann wavefront sensor. The Zernike coefficients describing the on-eye spherical aberration of the soft contact lens were compared with off-eye ray-tracing results. Paraxial and effective lens power changes were determined. RESULTS: The model predicts the on-eye spherical aberration of soft contact lenses closely. The resulting power change for a +/- 7.00 D spherical soft contact lens is +/- 0.5 D for a 6-mm pupil diameter and +/- 0.1 D for a 3-mm pupil diameter. Power change is negligible for soft contact lenses corrected for off-eye spherical aberration. CONCLUSIONS: For thin soft contact lenses, the level of spherical aberration and the consequent power change is similar on-eye and off-eye. Soft contact lenses corrected for spherical aberration in air will be expected to be aberration-free on-eye and produce only negligibly small power changes. For soft contact lenses without aberration correction, for higher levels of ametropia and large pupils, the soft contact lens power should be determined with trial lenses with their power and p value similar to the prescribed lens. The benefit of soft contact lenses corrected for spherical aberration depends on the level of ocular spherical aberration.     

Spherical aberration of the crystalline lens

Split beams of varying separations from a helium-neon laser were directed through the crystalline lenses of a number of vertebrates. Photographs of the focal effects indicate the extent to which the refractive index variation of the lens and lens shape control spherical aberration. Of the fish studied, only rock bass lenses are relatively free of spherical aberration. Both goldfish and yellow perch exhibit substantial amounts of positive spherical aberration. Varying amounts of negative spherical aberration are present in frog, juvenile duck, dog and rat lenses. Positive and negative spherical aberration is found in human and cat lenses while cow, pig, lamb and rabbit lenses are almost free of aberration.     

Comparison of the behavior of natural and refilled porcine lenses in a robotic lens stretcher

The mechanism by which the eye dynamically changes focal distance (accommodation), and the mechanism by which this ability is lost with age (presbyopia), are still contested. Due to inherent confounding factors in vivo, in vitro measurements have been undertaken using a robotic lens stretcher to examine these mechanisms as well as the efficacy of lens refilling - a proposed treatment for presbyopia. Dynamic forces, anterior and posterior curvatures, and lens thickness are all correlated for young natural and refilled porcine lenses. Comparisons are made to lenses refilled with a homogeneous polymer system. The amplitude of accommodation of the young porcine lens is very small such that it may be a suitable model for presbyopia. The behavior of refilled lenses was highly dependent on the refill volume. The volume could be tuned to maximize accommodative amplitude in the refilled lens.     

Optical power of the isolated human crystalline lens

PURPOSE: To characterize the age dependence of isolated human crystalline lens power and quantify the contributions of the lens surfaces and refractive index gradient. METHODS: Experiments were performed on 100 eyes of 73 donors (average 2.8 +/- 1.6 days postmortem) with an age range of 6 to 94 years. Lens power was measured with a modified commercial lensmeter or with an optical system based on the Scheiner principle. The radius of curvature and asphericity of the isolated lens surfaces were measured by shadow photography. For each lens, the contributions of the surfaces and the refractive index gradient to the measured lens power were calculated by using optical ray-tracing software. The age dependency of these refractive powers was assessed. RESULTS: The total refractive power and surface refractive power both showed a biphasic age dependency. The total power decreased at a rate of -0.41 D/y between ages 6 and 58.1, and increased at a rate of 0.33D/y between ages 58.1 and 82. The surface contribution decreased at a rate of -0.13 D/y between ages 6 and 55.2 and increased at a rate of 0.04 D/y between ages 55.2 and 94. The relative contribution of the surfaces increased by 0.17% per year. The equivalent refractive index also showed a biphasic age dependency with a decrease at a rate of -3.9 x 10(-4) per year from ages 6 to 60.4 followed by a plateau. CONCLUSIONS: The lens power decreases with age, due mainly to a decrease in the contribution of the gradient. The use of a constant equivalent refractive index value to calculate lens power with the lens maker formula will underestimate the power of young lenses and overestimate the power of older lenses.     

Systematic measurement errors involved in over‐refraction using an autorefractor (Grand‐Seiko WV‐500): is measurement of accommodative lag through spectacle lenses valid?

PURPOSE: Lags of accommodation in ametropic children are often evaluated through spectacle lenses (over-refraction). This study investigated the validity of over-refraction when using an autorefractor. METHODS: Using an autorefractor (Shin-Nippon SRW-500/Grand-Seiko WV-500), refractive readings were obtained in 25 cyclopleged eyes (mean +/- S.D. refraction: -3.44 +/- 3.56 D, range: from -10.56 to +0.25 D) while placing spherical lenses of different power (from -5.00 to +5.00 D) in front of the eye at a vertex distance of 12 mm. Based on the refractive readings with and without the lens, and the lens power, measurement errors were estimated. Similarly, the measurement errors were estimated also in model eyes of -10.00, -4.75, 0.00 and +10.00 D. The results were compared with ray-tracing simulations based on the internal specifications of the autorefractor. RESULTS: Measurement errors were found unless the power of the spectacle lens was equal to the refractive error of the eye. When the spectacle lens power was greater (less myopic or more hyperopic) than the refraction of the eye, the measurement error was negative in sign and greater than -0.3 D. It follows that, when an accommodative response is measured in myopic subjects, the refractive reading usually becomes more myopic than the refraction of the eye including the accommodative response; hence, the accommodative response is overestimated, and the lag of accommodation is underestimated. CONCLUSIONS: The autorefraction through spectacle lenses involved systematic measurement errors. The extent of the errors is usually small but needs to be taken into account in a comparative study of accommodative responses among different refractive groups.     

Contribution of the gradient refractive index and shape to the crystalline lens spherical aberration and astigmatism

The optical properties of the crystalline lens are determined by its shape and refractive index distribution. However, to date, those properties have not been measured together in the same lens, and therefore their relative contributions to optical aberrations are not fully understood. The shape, the optical path difference, and the focal length of ten porcine lenses (age around 6 months) were measured in vitro using Optical Coherence Tomography and laser ray tracing. The 3D Gradient Refractive Index distribution (GRIN) was reconstructed by means of an optimization method based on genetic algorithms. The optimization method searched for the parameters of a 4-variable GRIN model that best fits the distorted posterior surface of the lens in 18 different meridians. Spherical aberration and astigmatism of the lenses were estimated using computational ray tracing, with the reconstructed GRIN lens and an equivalent homogeneous refractive index. For all lenses the posterior radius of curvature was systematically steeper than the anterior one, and the conic constant of both the anterior and posterior positive surfaces was positive. In average, the measured focal length increased with increasing pupil diameter, consistent with a crystalline lens negative spherical aberration. The refractive index of nucleus and surface was reconstructed to an average value of 1.427 and 1.364, respectively, for 633 nm. The results of the GRIN reconstruction showed a wide distribution of the index in all lens samples. The GRIN shifted spherical aberration towards negative values when compared to a homogeneous index. A negative spherical aberration with GRIN was found in 8 of the 10 lenses. The presence of GRIN also produced a decrease in the total amount of lens astigmatism in most lenses, while the axis of astigmatism was only little influenced by the presence of GRIN. To our knowledge, this study is the first systematic experimental study of the relative contribution of geometry and GRIN to the aberrations in a mammal lens.     

The optics of the spherical fish lens.

The optical design of the fish eye is particularly simple because immersion renders the cornea optically ineffective and the lens is nearly spherical in shape. Measurements have shown that an approximately parabolic gradient of refractive index exists within the lens. If full internal and external spherical symmetry of the lens applies, the geometrical-optical behaviour of the lens is then a function only of the refractive index of the surrounding medium, that of the lens core and cortex, and of the form of the index gradient. The theoretical optical performance of models of the spherical fish lens is calculated by means of the ray-tracing program Drishti as a basis for understanding the optical design of real fish and aquatic eyes. Models based on the gradients proposed by earlier workers are shown to be unable to predict reported spherical aberration and image quality. A model of the fish lens with a polynomial gradient is proposed that yields spherical aberration, image quality and chromatic aberration similar to that reported for the fish.     

The optical modelling of the human lens

The effect of varying lens shape factors and refractive index distribution on two lens performance characteristics (equivalent power and spherical aberration) are considered, using a mathematical model of the human lens which is based upon ellipsoidal iso-indical contours. Values of radii of curvature based on the work of various authors are used to determine asphericity and these inferred values compared with previous measurements. Discrepancies are found and although asphericity has no effect on equivalent power, it does affect the spherical aberration. Based on preliminary findings of the refractive index distribution in the equatorial plane of human lenses, the index distribution is described by a polynomial in the Y (the distance from the optical axis in the equatorial plane), the coefficients of which are polynomials in Z (the distance along the optical axis). The shape of the index profile was found to have a significant effect on the equivalent power and spherical aberration of the lens. The results indicate that more information on surface asphericity and accurate measurement of the index profile in the sagittal plane are required for more accurate modelling of the human lens.     

Embryonic lens of the human eye as an optical structure

The spherical aberration of the excised embryonic (18 to 22 weeks) human lens was determined by photographing the refractive effects of the lens on fine parallel laser beams. All lenses showed little evidence of focal variation with laser position although a slight tendency toward positive (undercorrected) spherical aberration was noted. One lens from the eye of a newborn showed slight negative (overcorrected) aberration. It is assumed that the continued growth of the lens, with central compression of old tissue, produces a refractive index distribution which contributes to lens optical quality, even in the uterine environment. Frozen sections of embryo eyes of the same period (18 to 22 weeks) indicate that a major part of the change from a spherical to an elliptical lens shape takes place between the fourth and fifth month of development.     

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.     

Numerical study of the influence of the shell structure of the crystalline lens on the refractive properties of the human eye

In this paper, the numerical model of the refractive properties of the human eye is given. A special account is given of the laminated structure of the crystalline lens. The crystalline lens is presented in the form of hundreds of shells with rotational symmetry, and with the refractive index constant within each shell. The shells have the form of two semi-ellipsoids joined along the equator. The refractive index increases from the cortical shell to the inner one, according to the exponential dependency. The cornea, approximated by two ellipsoidal surfaces, is added in front of the crystalline lens. A ray-tracing procedure is applied to study the refractive properties of such a system: refractive power, spherical aberration and energy distribution. The optical properties of the given model are analysed by changing some parameters such as refractive index profile and number of shells. Calculations show that the gradient of the refractive index inside the crystalline lens results in the generation of many focal planes in such an optical system.     

Comparison of wavefront aberrations and optical quality of eyes implanted with five different intraocular lenses

PURPOSE: We compared corneal and total higher order wavefront aberrations in 25 pseudophakic eyes implanted with five different types of intraocular lenses to obtain an objective evaluation of the optical quality of these pseudophakic eyes. Five IOLs per type were studied. METHODS: Implanted lenses were the Pharmacia Tecnis Z9000 with negative spherical aberration, Pharmacia 911 Edge, Alcon Acrysof SA60AT and MA60BM, and Allergan Sensar AR40e. Eyes were examined using the Topcon KR-9000PW topographer/aberrometer, which obtains simultaneous coaxial measurements of corneal and ocular aberrations, and displays the calculated Point Spread Function (PSF) and Modulation Transfer Function (MTF). RESULTS: Corneal spherical aberration was positive in all tested eyes. For a 4-mm optical zone, ocular spherical aberration was 0.0054+/-0.0172 microm root-mean-square (RMS) in eyes implanted with the Tecnis lens, and was 0.0562 to 0.0974 microm RMS in eyes implanted with the four other conventional IOLs. A myopic refractive shift with mydriasis of -0.08 D occurred with the Tecnis IOL; it was -0.57 to -0.90 D with the conventional IOLs. Coma did not show a substantial reduction with any of the IOLs. Total wavefront aberrations showed nonsignificant reduction with the Tecnis lens. The PSF and the MTF also showed nonsignificant improvements over conventional IOLs. CONCLUSIONS: The optical quality of pseudophakic eyes can be measured in vivo by aberrometers. Different IOLs resulted in measurably different outcomes. In this preliminary study, compensation of the spherical aberration observed with the Tecnis lens confirmed the theoretical predictions associated with this lens and resulted in no myopic shift in refraction with mydriasis.     

On-eye spherical aberration of soft contact lenses and effective lens power

Purpose:  Soft contact lenses (SCL) produce a significant level of spherical aberration (SA). A simple model assuming that a thin SCL aligns to the cornea predicts that these effects are similar on-eye and off-eye. We investigate the effect SA has on the power of an SCL on-eye.
Methods:  The wavefront aberration for 17 eyes and 33 SCL on-eye was measured with a Shack–Hartmann wavefront sensor. The Zernike coefficients describing the on-eye SA of the SCL were compared with off-eye ray tracing results. Paraxial and effective lens power changes resulting from the SCL-induced SA were determined.
Results:  The model predicts the on-eye SA of SCL closely. The SA induced by spherical SCL partly cancelled the ocular SA for 11 of the subjects. The power change resulting from SCL-induced SA is ±0.5 D for a ±7.00 D spherical SCL on a 6-mm pupil. Power change is negligible for SCL corrected for off-eye SA.
Conclusions:  For thin SCL the level of SA is similar on-eye and off-eye. SCL corrected for off-eye SA are aberration free on-eye but the benefit depends on the individual level of ocular aberrations and the viewing condition. The effective power change of spherical SCL depends on pupil size and can be significant for large pupils even for moderate refractive errors. For SCL without aberration correction, for higher levels of ametropia and large pupils, the SCL power should be determined with trial SCL with their power and p -value similar to the prescribed lens.     

A rare trial eyeglass case with binocular trial lenses

In this article the author describes a rare trial frame case in the medical history collection of the Ruhr University at Bochum. It has 24 binocular trial lenses which are similar to be early "Nuremberg wire spectacles." The lens power is expressed as the focal length, measured in Rhenish inches. Converted into diopters, the refractive power of the lenses ranges from +/- 1.0 to +/- 8.0 D.spherical. The case also contains six pairs of plane lenses tinted in various intensities of azure blue and four pairs of plane lenses tinted smoke-gray. It contains no astigmatic lenses. Since the metric system, with the diopter as a unit of refractive power, was introduced in the optical industry in 1875, it may be assumed that this case was in use before then. However, the design of the binocular trial frames suggests that they may be considerably older.     

Optical and biometric relationships of the isolated pig crystalline lens

AIM: To investigate the interrelationships between optical and biometric properties of the porcine crystalline lens, to compare these findings with similar relationships found for the human lens and to attempt to fit this data to a geometric model of the optical and biometric properties of the pig lens. METHODS: Weight, focal length, spherical aberration, surface curvatures, thickness and diameters of 20 isolated pig lenses were measured and equivalent refractive index was calculated. These parameters were compared and used to geometrically model the pig lens. RESULTS: Linear relationships were identified between many of the lens biometric and optical properties. The existence of these relationships allowed a simple geometrical model of the pig lens to be calculated which offers predictions of the optical properties. CONCLUSIONS: The linear relationships found and the agreement observed between measured and modeled results suggest that the pig lens confirms to a predictable, preset developmental pattern and that the optical and biometric properties are predictably interrelated.     

Axial growth and changes in lenticular and corneal power during emmetropization in infants

PURPOSE: To evaluate the contribution made by the ocular components to the emmetropization of spherical equivalent refractive error in human infants between 3 and 9 months of age. METHODS: Keratophakometry in two meridians was performed on 222 normal-birthweight infant subjects at 3 and 9 months of age. The spherical equivalent refractive error was measured by cycloplegic retinoscopy (cyclopentolate 1%). Anterior chamber depth, lens thickness, and vitreous chamber depth were measured by A-scan ultrasonography over the closed eyelid. RESULTS: Both the mean and SD for spherical equivalent refractive error decreased between 3 and 9 months of age (+2.16 +/- 1.30 D at 3 months; +1.36 +/- 1.06 D at 9 months; P < 0.0001, for the change in both mean and SD). Average ocular component change was characterized by increases in axial length, thinning, and flattening of the crystalline lens, increases in lens equivalent refractive index, and decreases in lens and corneal power. Initial refractive error was associated in a nonlinear manner with the change in refractive error (R(2) = 0.41; P < 0.0001) and with axial growth (R(2) = 0.082; P = 0.0005). Reduction in hyperopia correlated significantly with increases in axial length (R(2) = 0.16; P < 0.0001), but not with changes in corneal and lenticular power. Decreases in lenticular and corneal power were associated with axial elongation (R(2) = 0.40, R(2) = 0.12, respectively; both P < 0.0001). CONCLUSIONS: Modulation in the amount of axial growth in relation to initial refractive error appeared to be the most influential factor in emmetropization of spherical equivalent refractive error. The associations between initial refractive error, subsequent axial growth, and change in refractive error were consistent with a visual basis for emmetropization. The cornea and crystalline lens lost substantial amounts of dioptric power in this phase of growth, but neither appeared to play a significant role in emmetropization.