Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus
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Auteurs : Ramkumar Sabesan ; Lynette Johns ; Olga Tomashevskaya ; Deborah S. Jacobs ; Perry Rosenthal ; Geunyoung YoonSource :
- Optometry and vision science : official publication of the American Academy of Optometry [ 1040-5488 ] ; 2013.
Abstract
To investigate the feasibility of correcting ocular higher order aberrations (HOA) in keratoconus (KC) using wavefront-guided optics in a scleral lens prosthetic device (SLPD).
Six advanced keratoconus patients (11 eyes) were fitted with a SLPD with conventional spherical optics. A custom-made Shack-Hartmann wavefront sensor was used to measure aberrations through a dilated pupil wearing the SLPD. The position of SLPD, i.e. horizontal and vertical decentration relative to the pupil and rotation were measured and incorporated into the design of the wavefront-guided optics for the customized SLPD. A submicron-precision lathe created the designed irregular profile on the front surface of the device. The residual aberrations of the same eyes wearing the SLPD with wavefront-guided optics were subsequently measured. Visual performance with natural mesopic pupil was compared between SLPDs having conventional spherical and wavefront-guided optics by measuring best-corrected high-contrast visual acuity and contrast sensitivity.
Root-mean-square of HOA(RMS) in the 11 eyes wearing conventional SLPD with spherical optics was 1.17±0.57μm for a 6 mm pupil. HOA were effectively corrected by the customized SLPD with wavefront-guided optics and RMS was reduced 3.1 times on average to 0.37±0.19μm for the same pupil. This correction resulted in significant improvement of 1.9 lines in mean visual acuity (p<0.05). Contrast sensitivity was also significantly improved by a factor of 2.4, 1.8 and 1.4 on average for 4, 8 and 12 cycles/degree, respectively (p<0.05 for all frequencies). Although the residual aberration was comparable to that of normal eyes, the average visual acuity in logMAR with the customized SLPD was 0.21, substantially worse than normal acuity.
The customized SLPD with wavefront-guided optics corrected the HOA of advanced KC patients to normal levels and improved their vision significantly.
Url:
DOI: 10.1097/OPX.0b013e318288d19c
PubMed: 23478630
PubMed Central: 4871146
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PMC:4871146Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus</title>
<author><name sortKey="Sabesan, Ramkumar" sort="Sabesan, Ramkumar" uniqKey="Sabesan R" first="Ramkumar" last="Sabesan">Ramkumar Sabesan</name>
</author>
<author><name sortKey="Johns, Lynette" sort="Johns, Lynette" uniqKey="Johns L" first="Lynette" last="Johns">Lynette Johns</name>
</author>
<author><name sortKey="Tomashevskaya, Olga" sort="Tomashevskaya, Olga" uniqKey="Tomashevskaya O" first="Olga" last="Tomashevskaya">Olga Tomashevskaya</name>
</author>
<author><name sortKey="Jacobs, Deborah S" sort="Jacobs, Deborah S" uniqKey="Jacobs D" first="Deborah S." last="Jacobs">Deborah S. Jacobs</name>
</author>
<author><name sortKey="Rosenthal, Perry" sort="Rosenthal, Perry" uniqKey="Rosenthal P" first="Perry" last="Rosenthal">Perry Rosenthal</name>
</author>
<author><name sortKey="Yoon, Geunyoung" sort="Yoon, Geunyoung" uniqKey="Yoon G" first="Geunyoung" last="Yoon">Geunyoung Yoon</name>
</author>
</titleStmt>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus</title>
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</author>
<author><name sortKey="Johns, Lynette" sort="Johns, Lynette" uniqKey="Johns L" first="Lynette" last="Johns">Lynette Johns</name>
</author>
<author><name sortKey="Tomashevskaya, Olga" sort="Tomashevskaya, Olga" uniqKey="Tomashevskaya O" first="Olga" last="Tomashevskaya">Olga Tomashevskaya</name>
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<author><name sortKey="Jacobs, Deborah S" sort="Jacobs, Deborah S" uniqKey="Jacobs D" first="Deborah S." last="Jacobs">Deborah S. Jacobs</name>
</author>
<author><name sortKey="Rosenthal, Perry" sort="Rosenthal, Perry" uniqKey="Rosenthal P" first="Perry" last="Rosenthal">Perry Rosenthal</name>
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<author><name sortKey="Yoon, Geunyoung" sort="Yoon, Geunyoung" uniqKey="Yoon G" first="Geunyoung" last="Yoon">Geunyoung Yoon</name>
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<series><title level="j">Optometry and vision science : official publication of the American Academy of Optometry</title>
<idno type="ISSN">1040-5488</idno>
<idno type="eISSN">1538-9235</idno>
<imprint><date when="2013">2013</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">To investigate the feasibility of correcting ocular higher order aberrations (HOA) in keratoconus (KC) using wavefront-guided optics in a scleral lens prosthetic device (SLPD).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Six advanced keratoconus patients (11 eyes) were fitted with a SLPD with conventional spherical optics. A custom-made Shack-Hartmann wavefront sensor was used to measure aberrations through a dilated pupil wearing the SLPD. The position of SLPD, i.e. horizontal and vertical decentration relative to the pupil and rotation were measured and incorporated into the design of the wavefront-guided optics for the customized SLPD. A submicron-precision lathe created the designed irregular profile on the front surface of the device. The residual aberrations of the same eyes wearing the SLPD with wavefront-guided optics were subsequently measured. Visual performance with natural mesopic pupil was compared between SLPDs having conventional spherical and wavefront-guided optics by measuring best-corrected high-contrast visual acuity and contrast sensitivity.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Root-mean-square of HOA(RMS) in the 11 eyes wearing conventional SLPD with spherical optics was 1.17±0.57μm for a 6 mm pupil. HOA were effectively corrected by the customized SLPD with wavefront-guided optics and RMS was reduced 3.1 times on average to 0.37±0.19μm for the same pupil. This correction resulted in significant improvement of 1.9 lines in mean visual acuity (p<0.05). Contrast sensitivity was also significantly improved by a factor of 2.4, 1.8 and 1.4 on average for 4, 8 and 12 cycles/degree, respectively (p<0.05 for all frequencies). Although the residual aberration was comparable to that of normal eyes, the average visual acuity in logMAR with the customized SLPD was 0.21, substantially worse than normal acuity.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The customized SLPD with wavefront-guided optics corrected the HOA of advanced KC patients to normal levels and improved their vision significantly.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8904931</journal-id>
<journal-id journal-id-type="pubmed-jr-id">6277</journal-id>
<journal-id journal-id-type="nlm-ta">Optom Vis Sci</journal-id>
<journal-id journal-id-type="iso-abbrev">Optom Vis Sci</journal-id>
<journal-title-group><journal-title>Optometry and vision science : official publication of the American Academy of Optometry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1040-5488</issn>
<issn pub-type="epub">1538-9235</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23478630</article-id>
<article-id pub-id-type="pmc">4871146</article-id>
<article-id pub-id-type="doi">10.1097/OPX.0b013e318288d19c</article-id>
<article-id pub-id-type="manuscript">NIHMS448113</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Wavefront-Guided Scleral Lens Prosthetic Device for Keratoconus</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sabesan</surname>
<given-names>Ramkumar</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Johns</surname>
<given-names>Lynette</given-names>
</name>
<degrees>OD, FAAO</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Tomashevskaya</surname>
<given-names>Olga</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Jacobs</surname>
<given-names>Deborah S.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Rosenthal</surname>
<given-names>Perry</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Yoon</surname>
<given-names>Geunyoung</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<aff id="A1">Flaum Eye Institute, University of Rochester, Rochester, New York (RS, GY), and Boston Foundation for Sight, Needham, Massachusetts (LJ, OT, DSJ, PR)</aff>
</contrib-group>
<author-notes><corresp id="FN1">Corresponding author: Ramkumar Sabesan, G3183A, Box 314, Flaum Eye Institute, University of Rochester, Rochester, NY 14624, <email>ramkumar@optics.rochester.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>12</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>4</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>18</day>
<month>5</month>
<year>2016</year>
</pub-date>
<volume>90</volume>
<issue>4</issue>
<fpage>314</fpage>
<lpage>323</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/OPX.0b013e318288d19c</pmc-comment>
<abstract><sec id="S1"><title>Purpose</title>
<p id="P1">To investigate the feasibility of correcting ocular higher order aberrations (HOA) in keratoconus (KC) using wavefront-guided optics in a scleral lens prosthetic device (SLPD).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Six advanced keratoconus patients (11 eyes) were fitted with a SLPD with conventional spherical optics. A custom-made Shack-Hartmann wavefront sensor was used to measure aberrations through a dilated pupil wearing the SLPD. The position of SLPD, i.e. horizontal and vertical decentration relative to the pupil and rotation were measured and incorporated into the design of the wavefront-guided optics for the customized SLPD. A submicron-precision lathe created the designed irregular profile on the front surface of the device. The residual aberrations of the same eyes wearing the SLPD with wavefront-guided optics were subsequently measured. Visual performance with natural mesopic pupil was compared between SLPDs having conventional spherical and wavefront-guided optics by measuring best-corrected high-contrast visual acuity and contrast sensitivity.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Root-mean-square of HOA(RMS) in the 11 eyes wearing conventional SLPD with spherical optics was 1.17±0.57μm for a 6 mm pupil. HOA were effectively corrected by the customized SLPD with wavefront-guided optics and RMS was reduced 3.1 times on average to 0.37±0.19μm for the same pupil. This correction resulted in significant improvement of 1.9 lines in mean visual acuity (p<0.05). Contrast sensitivity was also significantly improved by a factor of 2.4, 1.8 and 1.4 on average for 4, 8 and 12 cycles/degree, respectively (p<0.05 for all frequencies). Although the residual aberration was comparable to that of normal eyes, the average visual acuity in logMAR with the customized SLPD was 0.21, substantially worse than normal acuity.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">The customized SLPD with wavefront-guided optics corrected the HOA of advanced KC patients to normal levels and improved their vision significantly.</p>
</sec>
</abstract>
<kwd-group><kwd>keratoconus</kwd>
<kwd>higher order aberrations</kwd>
<kwd>contact lens</kwd>
<kwd>Boston scleral lens</kwd>
<kwd>wavefront-guided treatment</kwd>
<kwd>visual acuity</kwd>
<kwd>contrast sensitivity</kwd>
<kwd>neural adaptation and plasticity</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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