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Biomedical subjects

Patricia Piers

Publications and source records attributed to Patricia Piers.

4 recordsLinked to original sources

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↗

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↗

Adaptive optics visual simulator.

PURPOSE: To develop a prototype instrument that uses adaptive optics to introduce virtually any desired aberration profile in a subject's eye. At the same time, the instrument could be used to evaluate the subject's spatial vision for each controlled aberration profile. This "aberration testing station" or "visual simulator" allows us to study the relationship between specific aberrations and visual quality. METHODS: The apparatus uses infrared light to measure the wavefront aberration of the system plus the eye with a Hartmann-Shack wavefront sensor. Defocus is added (or removed) with a computer-controlled, motorized optometer, while higher order aberrations are introduced by a 37-channel membrane deformable mirror. A parallel viewing channel is used for visual testing with the instrument. Visual acuity, contrast sensitivity, and other visual tests are performed under normal viewing for each desired aberration profile. RESULTS: The range of defocus that can be added is nearly unlimited, while the maximum amount of other aberration modes is restricted to approximately 0.5 microm, depending on mode. Pure modes or any selected combination of modes can be produced with high repeatability and precision (usually better than 0.05 microm), and the system works for pupil diameters up to 6 mm (with a natural pupil). CONCLUSIONS: The adaptive optics visual simulator is a powerful, non-invasive tool to evaluate how aberrations affect vision. In addition, it can be used for the interactive design and testing of new ophthalmic devices, and for the simulation of visual outcomes in customized refractive surgery.

Astigmatism↗