Search PubMed⌕ Search

Biomedical subjects

Antonio Guirao

Publications and source records attributed to Antonio Guirao.

9 recordsLinked to original sources

A method to predict refractive errors from wave aberration data.

We explored the impact of the eye's higher-order aberrations on subjective refraction comparing two classes of methods for estimating refractive state, one based directly on the wave aberration defined in the pupil plane and another based on the retinal image plane. The method defined in the pupil plane chose the sphere and cylinder that either minimized the wave aberration root mean square or minimized the sum of all the spherical and cylindrical components in the wave aberration. The method defined in the image plane chose the sphere and cylinder that optimized an image-quality metric such as the Strehl intensity ratio, the entropy and the intensity variance of the point-spread function, the volume under the modulation transfer function, or the volume under the contrast-sensitivity function. All these methods were compared in a population of six eyes for which we measured both the wave aberration with a Shack-Hartmann wavefront sensor and the subjective refraction under identical conditions. Pupil plane methods predicted subjective refraction poorly. The mean absolute error of the prediction, in spherical equivalent, was about 0.5 D (range, 0.1 to 0.8 D) and increased with increases in higher-order aberrations. However, for all the retinal image plane methods, the mean error between predicted and subjective refraction was about 0.1 D (range, 0 to 0.25 D). The reliability of the method based on the image-quality optimization was further confirmed in a large population of 146 eyes. In conclusion, higher-order aberrations influence the amount of sphere and cylinder required to correct vision. The results indicate that subjective refraction can be predicted from the eye's optics alone by optimizing computed retinal image quality.

Adult↗

Corneal optical aberrations and retinal image quality in patients in whom monofocal intraocular lenses were implanted.

OBJECTIVES: To compare retinal image quality and optical corneal aberrations in patients in whom monofocal polymethyl methacrylate intraocular lenses (IOLs) were implanted with those in healthy subjects of a similar older age (60-70 years old) and to use the results to suggest improved optical designs of IOLs to maximize retinal image quality. METHODS: A double-pass apparatus was used to measure retinal image quality for 3-, 4-, and 6-mm pupil diameters. Corneal aberrations for a 4-mm pupil were calculated by a ray-tracing technique from the elevations provided by corneal topography. Two groups of 20 subjects of a similar older age were studied: in one group, polymethyl methacrylate monofocal IOLs were implanted; and in a second group, healthy subjects were used as a reference. RESULTS: The average retinal image quality was similar in older healthy patients and in patients in whom IOLs were implanted, with both groups having a significantly worse image quality than healthy younger subjects (aged 20-30 years). Both groups were more tolerant to defocus than younger subjects. CONCLUSIONS: The average retinal image quality of patients in whom IOLs were implanted was worse than that of healthy younger subjects despite the good optical quality of isolated IOLs. This apparent paradox can be understood by the nature of the aberration coupling in the eyes that undergo implantation. The ideal substitute for the natural lens is not an IOL with the best-isolated optical performance, but rather one designed to compensate for the aberrations of the cornea-a design somehow inspired by the crystalline lens of younger subjects.

Aged↗

Calculated impact of higher-order monochromatic aberrations on retinal image quality in a population of human eyes.

We calculated the impact of higher-order aberrations on retinal image quality and the magnitude of the visual benefit expected from their correction in a large population of human eyes. Wave aberrations for both eyes of 109 normal subjects and 4 keratoconic patients were measured for 3-, 4-, and 5.7-mm pupils with a Shack-Hartmann sensor. Retinal image quality was estimated by means of the modulation transfer function (MTF) in white light. The visual benefit was calculated as the ratio of the MTF when the monochromatic higher-order aberrations are corrected to the MTF corresponding to the best correction of defocus and astigmatism. On average, the impact of the higher-order aberrations for a 5.7-mm pupil in normal eyes is similar to an equivalent defocus of approximately 0.3 D. The average visual benefit for normal eyes at 16 c/deg is approximately 2.5 for a 5.7-mm pupil and is negligible for small pupils (1.25 for a 3-mm pupil). The benefit varies greatly among eyes, with some normal eyes showing almost no benefit and others a benefit higher than 4 at 16 c/deg across a 5.7-mm pupil. The benefit for keratoconic eyes is much larger. The benefit at 16 c/deg is 12 and 3 for 5.7- and 3-mm pupils, respectively, averaged across four keratoconics. These theoretical benefits could be realized in normal viewing conditions but only under specific conditions.

Adult↗

Method for optimizing the correction of the eye's higher-order aberrations in the presence of decentrations.

The use of a correcting element to compensate for higher-order aberrations in an optical system often requires accurate alignment of the correcting element. This is not always possible, as in the case of a contact lens on the eye. We propose a method consisting of partial correction of every aberration term to minimize the average variance of the residual wave-front aberration produced by Gaussian decentrations (translations and rotations). Analytical expressions to estimate the fraction of every aberration term that should be corrected for a given amount of decentration are derived. To demonstrate the application of this method, three examples are used to compare performance with total and with partial correction. The partial correction is more robust and always yields some benefit regardless of the amount of decentration.

Humans↗

Contribution of the cornea and internal surfaces to the change of ocular aberrations with age.

We studied the age dependence of the relative contributions of the aberrations of the cornea and the internal ocular surfaces to the total aberrations of the eye. We measured the wave-front aberration of the eye with a Hartmann-Shack sensor and the aberrations of the anterior corneal surface from the elevation data provided by a corneal topography system. The aberrations of the internal surfaces were obtained by direct subtraction of the ocular and corneal wave-front data. Measurements were obtained for normal healthy subjects with ages ranging from 20 to 70 years. The magnitude of the RMS wave-front aberration (excluding defocus and astigmatism) of the eye increases more than threefold within the age range considered. However, the aberrations of the anterior corneal surface increase only slightly with age. In most of the younger subjects, total ocular aberrations are lower than corneal aberrations, while in the older subjects the reverse condition occurs. Astigmatism, coma, and spherical aberration of the cornea are larger than in the complete eye in younger subjects, whereas the contrary is true for the older subjects. The internal ocular surfaces compensate, at least in part, for the aberrations associated with the cornea in most younger subjects, but this compensation is not present in the older subjects. These results suggest that the degradation of the ocular optics with age can be explained largely by the loss of the balance between the aberrations of the corneal and the internal surfaces.

Adult↗

Calculated impact of higher-order monochromatic aberrations on retinal image quality in a population of human eyes.

We calculated the impact of higher-order aberrations on retinal image quality and the magnitude of the visual benefit expected from their correction in a large population of human eyes. Wave aberrations for both eyes of 109 normal subjects and 4 keratoconic patients were measured for 3-, 4-, and 5.7-mm pupils with a Shack-Hartmann sensor. Retinal image quality was estimated by means of the modulation transfer function (MTF) in white light. The visual benefit was calculated as the ratio of the MTF when the monochromatic higher-order aberrations are corrected to the MTF corresponding to the best correction of defocus and astigmatism. On average, the impact of the higher-order aberrations for a 5.7-mm pupil in normal eyes is similar to an equivalent defocus of approximately 0.3 D. The average visual benefit for normal eyes at 16 c/deg is approximately 2.5 for a 5.7-mm pupil and is negligible for small pupils (1.25 for a 3-mm pupil). The benefit varies greatly among eyes, with some normal eyes showing almost no benefit and others a benefit higher than 4 at 16 c/deg across a 5.7-mm pupil. The benefit for keratoconic eyes is much larger. The benefit at 16 c/deg is 12 and 3 for 5.7- and 3-mm pupils, respectively, averaged across four keratoconics. These theoretical benefits could be realized in normal viewing conditions but only under specific conditions.

Adult↗

Peripheral refractive errors in myopic, emmetropic, and hyperopic young subjects.

To gain more insight into the relationship between foveal and peripheral refractive errors in humans, spheres, cylinders, and their axes were binocularly measured across the visual field in myopic, emmetropic, and hyperopic groups of young subjects. Both automated infrared photorefraction (the "PowerRefractor"; www. plusoptix.de) and a double-pass technique were used because the PowerRefractor provided extensive data from the central 44 deg of the visual field in a very convenient and fast way. Two-dimensional maps for the average cross cylinders and spherical equivalents, as well as for the axes of the power meridians of the cylinders, were created. A small amount of lower-field myopia was detected with a significant vertical gradient in spherical equivalents. In the central visual field there was little difference among the three refractive groups. The established double-pass technique provided complementary data also from the far periphery. At 45 deg eccentricity the double-pass technique revealed relatively more hyperopic spherical equivalents in myopic subjects than in emmetropic subjects [+/-2.73 +/- 2.85 D relative to the fovea, p < 0.01 (+/- standard deviation)] and more myopic spherical equivalents in hyperopic subjects (-3.84 +/- 2.86 D relative to the fovea, p < 0.01). Owing to the pronounced peripheral astigmatism, spherical equivalents (refractions with respect to the plane of the circle of least confusion) became myopic relative to the fovea in all three groups. The finding of general peripheral myopia was unexpected. Its possible roles in foveal refractive development are discussed.

Adult↗

Effect of beam size on the expected benefit of customized laser refractive surgery.

PURPOSE: Customized laser surgery attempts to correct higher order aberrations, as well as defocus and astigmatism. The success of such a procedure depends on using a laser beam that is small enough to produce fine ablation profiles needed to correct higher order aberrations. METHODS: Wave aberrations were obtained from a population of 109 normal eyes and 4 keratoconic eyes using a Shack-Hartmann wavefront sensor. We considered a theoretical customized ablation in each eye, performed with beams of 0.5, 1.0, 1.5, and 2.0 mm in diameter. We then calculated the residual aberrations remaining in the eye for the different beam sizes. Retinal image quality was estimated by means of the modulation transfer function (MTF), computed from the residual aberrations. Fourier analysis was used to study spatial filtering of each beam size. RESULTS: The laser beam acts like a spatial filter, smoothing the finest features in the ablation profile. The quality of the correction declines steadily when the beam size increases. A beam of 2 mm is capable of correcting defocus and astigmatism. Beam diameters of 1 mm or less may effectively correct aberrations up to fifth order. CONCLUSION: Large diameter laser beams decrease the ability to correct higher order aberrations. A top-hat laser beam of 1 mm (Gaussian with FWHM of 0.76 mm) is small enough to produce a customized ablation for typical human eyes.

Adult↗