Vicente J. Camps

Three-dimensional point spread function of multilayered flat lenses and its application to extreme subwavelength resolution

The three-dimensional (3D) point spread function (PSF) of multilayered flat lenses was proposed in order to characterize the diffractive behavior of these subwavelength image formers. We computed the polarization-dependent scalar 3D PSF for a wide range of slab widths and for different dissipative metamaterials. In terms similar to the Rayleigh criterion we determined unambiguously the limit of resolution featuring this type of image-forming device. We investigated the significant reduction of the limit of resolution by increasing the number of layers, which may drop nearly 1 order of magnitude. However, this super-resolving effect is obtained in detriment of reducing the depth of field. Limitations exist on the formation of 3D images.

Clinical validation of an algorithm to correct the error in the keratometric estimation of corneal power in normal eyes

PURPOSE: To validate clinically in a normal healthy population an algorithm to correct the error in the keratometric estimation of corneal power based on the use of a variable keratometric index of refraction (nk). SETTING: Medimar International Hospital (Oftalmar) and University of Alicante, Alicante, Spain. DESIGN: Case series. METHODS: Corneal power was measured with a Scheimpflug photography–based system (Pentacam software version 1.14r01) in healthy eyes with no previous ocular surgery. In all cases, keratometric corneal power was also estimated using an adjusted value of nk that is dependent on the anterior corneal radius (r1c) as follows: nkadj = −0.0064286 r1c +1.37688. Agreement between the Gaussian (PcGauss) and adjusted keratometric (Pkadj) corneal power values was evaluated. RESULTS: The study evaluated 92 eyes (92 patients; age range 15 to 64 years). The mean difference between PcGauss and Pkadj was −0.02 diopter (D) ± 0.22 (SD) (P=.43). A very strong, statistically significant correlation was found between both corneal powers (r = .994, P<.01). The range of agreement between PcGauss and Pkadj was 0.44 D, with limits of agreement of −0.46 and +0.42 D. In addition, a very strong, statistically significant correlation of the difference between PcGauss and Pkadj and the posterior corneal radius was found (r = 0.96, P<.01). CONCLUSION: The imprecision in the calculation of corneal power using keratometric estimation can be minimized in clinical practice by using a variable keratometric index that depends on the radius of the anterior corneal surface. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

New approach for correction of error associated with keratometric estimation of corneal power in keratoconus.

Purpose: The aim of this study was to obtain the exact value of the keratometric index (nkexact) and to clinically validate a variable keratometric index (nkadj) that minimizes this error. Methods: The nkexact value was determined by obtaining differences (&Dgr;Pc) between keratometric corneal power (Pk) and Gaussian corneal power ( ) equal to 0. The nkexact was defined as the value associated with an equivalent difference in the magnitude of &Dgr;Pc for extreme values of posterior corneal radius (r2c) for each anterior corneal radius value (r1c). This nkadj was considered for the calculation of the adjusted corneal power (Pkadj). Values of r1c ∈ (4.2, 8.5) mm and r2c ∈ (3.1, 8.2) mm were considered. Differences of True Net Power with , Pkadj, and Pk(1.3375) were calculated in a clinical sample of 44 eyes with keratoconus. Results: nkexact ranged from 1.3153 to 1.3396 and nkadj from 1.3190 to 1.3339 depending on the eye model analyzed. All the nkadj values adjusted perfectly to 8 linear algorithms. Differences between Pkadj and did not exceed ±0.7 D (Diopter). Clinically, nk = 1.3375 was not valid in any case. Pkadj and True Net Power and Pk(1.3375) and Pkadj were statistically different (P < 0.01), whereas no differences were found between and Pkadj (P > 0.01). Conclusions: The use of a single value of nk for the calculation of the total corneal power in keratoconus has been shown to be imprecise, leading to inaccuracies in the detection and classification of this corneal condition. Furthermore, our study shows the relevance of corneal thickness in corneal power calculations in keratoconus.

Reliability in perimetric multichannel contrast sensitivity measurements.

In this study, the reliability of perimetric contrast sensitivity measurements favouring the achromatic, the red‐green and the blue‐yellow post‐receptorial mechanisms was analysed.The ATD multichannel perimeter was built thanks to the support of the Spanish Ministerio de Ciencia y Tecnologia Grants DPI2000-0116-P4-02 and PTR 1995-0909-OP, in collaboration with INDUSTRIAS DE OPTICA SA (San Cugat del Valles, Spain).

Minimizing the IOL power error induced by keratometric power.

Purpose To evaluate theoretically in normal eyes the influence on IOL power (PIOL) calculation of the use of a keratometric index (nk) and to analyze and validate preliminarily the use of an adjusted keratometric index (nkadj) in the IOL power calculation (PIOLadj). Methods A model of variable keratometric index (nkadj) for corneal power calculation (Pc) was used for IOL power calculation (named PIOLadj). Theoretical differences (&Dgr;PIOL) between the new proposed formula (PIOLadj) and which is obtained through Gaussian optics ( ) were determined using Gullstrand and Le Grand eye models. The proposed new formula for IOL power calculation (PIOLadj) was prevalidated clinically in 81 eyes of 81 candidates for corneal refractive surgery and compared with Haigis, HofferQ, Holladay, and SRK/T formulas. Results A theoretical PIOL underestimation greater than 0.5 diopters was present in most of the cases when nk = 1.3375 was used. If nkadj was used for Pc calculation, a maximal calculated error in &Dgr;PIOL of ±0.5 diopters at corneal vertex in most cases was observed independently from the eye model, r1c, and the desired postoperative refraction. The use of nkadj in IOL power calculation (PIOLadj) could be valid with effective lens position optimization nondependent of the corneal power. Conclusions The use of a single value of nk for Pc calculation can lead to significant errors in PIOL calculation that may explain some IOL power overestimations with conventional formulas. These inaccuracies can be minimized by using the new PIOLadj based on the algorithm of nkadj.

Holographic lens recorded on photopolymers: fabrication and study of the image quality

In recent years, holographic optical elements have been introduced in different applications such as high-density data storage, interconnections, spatial and temporal filters and three-dimensional displays. Simultaneously, more sensitive, efficient and durable holographic materials have been developed. Thus it is necessary to analyze the characteristics of these elements in the holographic materials developed. In this paper a method to obtain holographic lenses in a photopolymer is presented. In order to obtain, reconstruct and analyze these lenses, an optical device was designed. Once the holographic lenses are obtained, the device allows us to capture the images provided by these lenses. The imaging quality of these lenses was evaluated by means of the modulation transfer function (MTF) and the contrast. Lenses of different focal lengths were recorded. The holographic lenses obtained had high diffraction efficiency and temporal stability. Moreover, the resolution was greater than that of other lenses with the same diaphragm number.

Error induced by the estimation of the corneal power and the effective lens position with a rotationally asymmetric refractive multifocal intraocular lens

AIM To evaluate the prediction error in intraocular lens (IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position (ELP). METHODS Retrospective study including a total of 25 eyes of 13 patients (age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL (Oculentis GmbH, Germany). In all cases, an adjusted IOL power (PIOLadj) was calculated based on Gaussian optics using a variable keratometric index value (nkadj) for the estimation of the corneal power (Pkadj) and on a new value for ELP (ELPadj) obtained by multiple regression analysis. This PIOLadj was compared with the IOL power implanted (PIOLReal) and the value proposed by three conventional formulas (Haigis, Hoffer Q and Holladay I). RESULTS PIOLReal was not significantly different than PIOLadj and Holladay IOL power (P>0.05). In the Bland and Altman analysis, PIOLadj showed lower mean difference (-0.07 D) and limits of agreement (of 1.47 and -1.61 D) when compared to PIOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELPadj was significantly lower than ELP calculated with other conventional formulas (P<0.01) and was found to be dependent on axial length, anterior chamber depth and Pkadj. CONCLUSION Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing the keratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.

Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (PIOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (nkadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELPadj). PIOLadj was compared to the real IOL power implanted (PIOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between PIOLReal and PIOLadj when ELPadj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, PIOLReal was significantly higher when compared to PIOLadj without using ELPadj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.

Simulation of the Effect of Different Presbyopia-Correcting Intraocular Lenses With Eyes With Previous Laser Refractive Surgery

PURPOSE To simulate the optical performance of three presbyopia-correcting intraocular lenses (IOLs) implanted in eyes with previous laser refractive surgery. METHODS A simulation of the through-focus modulation transfer function (MTF) was performed for three presbyopia-correcting IOLs (Mplus, Oculentis GmbH, Berlin, Germany; Symfony, Johnson & Johnson Vision, Santa Ana, CA; and Mini Well, SIFI S.p.A., Lavinaio, Italy) in one eye with previous myopic LASIK and another with hyperopic LASIK. Real topographic data and the wavefront aberration profile of each IOL obtained with a Hartmann-Shack sensor were used. RESULTS In the eye with myopic LASIK, all IOLs lost optical quality at near and intermediate distances for 4- and 4.7-mm pupil size. For 3-mm pupil size, the Mini Well IOL showed the best intermediate and near MTF and maintained the far focus independently of the pupil. In the eye with hyperopic LASIK, the Mini Well IOL showed an intermediate, distance, and -4.00-diopter (D) foci for all pupils. The Symfony IOL showed a depth of focus at far and intermediate distance for 3-mm and a focus at -2.50 D in the rest. The Mplus showed a focus of -4.50 and -3.00 D for the 3- and 4-mm pupil, respectively. CONCLUSIONS The Mini Well and Symfony IOLs seem to work better than the Mplus IOL in eyes with previous myopic LASIK. With previous hyperopic LASIK, the Mini Well IOL seems to be able to provide acceptable near, intermediate, and far foci for all pupil sizes. These findings should be confirmed in future clinical studies. [J Refract Surg. 2018;34(4):222-227.].

In Vitro Aberrometric Assessment of a Multifocal Intraocular Lens and Two Extended Depth of Focus IOLs

Purpose To analyze the “in vitro” aberrometric pattern of a refractive IOL and two extended depth of focus IOLs. Methods A special optical bench with a Shack-Hartmann wavefront sensor (SH) was designed for the measurement. Three presbyopia correction IOLs were analyzed: Mini WELL (MW), TECNIS Symfony ZXR00 (SYM), and Lentis Mplus X LS-313 MF30 (MP). Three different pupil sizes were used for the comparison: 3, 4, and 4.7 mm. Results MW generated negative primary and positive secondary spherical aberrations (SA) for the apertures of 3 mm (−0.13 and +0.12 μm), 4 mm (−0.12 and +0.08 μm), and 4.7 mm (−0.11 and +0.08 μm), while the SYM only generated negative primary SA for 4 and 4.7 mm apertures (−0.12 μm and −0.20 μm, resp.). The MP induced coma and trefoil for all pupils and showed significant HOAs for apertures of 4 and 4.7 mm. Conclusions In an optical bench, the MW induces negative primary and positive secondary SA for all pupils. The SYM aberrations seem to be pupil dependent; it does not produce negative primary SA for 3 mm but increases for higher pupils. Meanwhile, the HOAs for the MW and SYM were not significant. The MP showed in all cases the highest HOAs.