Digital Challenges: Investigating Computer Vision Syndrome in Thai Esports Through a Case-Control Approach.

Purpose: To determine the factors associated with eyestrain in esports athletes in Bangkok compared with controls. Patients and Methods: A cross-sectional descriptive study was conducted between April and June 2023, involving 160 male participants (aged 20-35 years) who used digital devices, consisting of esports athletes and a control group. Data were collected using a general information questionnaire, Computer Vision Syndrome Questionnaire (CVS-Q), and Depression anxiety stress scale-21 (DASS-21). Ophthalmic instruments were used for the eye examinations by an optometrist. Results: Seventy-six esports athletes showed significantly lower visual performance than controls in logMAR visual acuity (p < 0.020), phoria (p < 0.001), negative fusional vergence (blur, break, and recovery) (p < 0.012, p < 0.004 and p < 0.039), positive fusional vergence (blur, break, and recovery) (p < 0.005, p < 0.001 and p < 0.005), monocular estimation method (p < 0.001), monocular and binocular accommodative facility (p < 0.001), and vergence facility (p < 0.001). A study on risk factors for CVS found that esports athletes were significantly more likely to have CVS (p < 0.001). Work environments with high-intensity lighting significantly increase the risk of CVS compared to low-intensity lighting (p < 0.001). The use of a digital device for >4 h/day, having a history of alcohol consumption, and stress significantly increased the risk of CVS (p < 0.001, p < 0.023, p < 0.048). Conclusion: This study found that esports athletes experienced vision health problems, indicating the need to prevent eyestrain caused by the use of digital devices.

Investigating the influence of eye-catching effect on mental workload in highway tunnel entrances: a comprehensive analysis of eye blink behavior.

OBJECTIVE: The objective of this study was to investigate the relationship between eye-catching effects and mental workload at highway tunnel entrances. Specifically, the study aimed to analyze drivers' eye blink behavior to gain a comprehensive understanding of how visual attraction at tunnel entrances affects cognitive workload. METHODS: 50 participants were recruited for the naturalistic driving experiment. Four different visually attractive driving scenarios (baseline, landscape-style architecture, tip slogan, and billboard) were selected. Eye-tracking technology was utilized to record and analyze the eye blink behavior of participating drivers. Various metrics, including blink frequency, blink duration, inter-blink interval, and pupil diameter after a blink, were measured and compared across different scenarios. RESULTS: The results of the study demonstrated significant differences in drivers' eye blink behavior across the different experimental scenarios, indicating the influence of visual attraction conditions on mental workload. The presence of eye-catching stimuli (landscape-style architecture, tip slogan, and billboard scenarios) at tunnel entrances resulted in decreased blink frequency, shorter blink duration, longer inter-blink intervals, and larger pupil diameter after a blink compared to when no specific eye-catching stimuli were present (baseline condition). These findings suggest that visual attractions capture drivers' attention, leading to increased cognitive workload and attentional demands. CONCLUSIONS: The findings of this study contribute to the existing literature on driver attention and mental workload, particularly in relation to eye-catching effect in tunnel environments. The presence of eye-catching stimuli at tunnel entrances can distract drivers and increase their mental workload, potentially compromising driving performance and safety. It is crucial for transportation authorities and designers to carefully consider the design and placement of visual attractions in tunnel entrances to minimize distraction and cognitive workload. By doing so, driving safety and performance can be enhanced in tunnel entrances.

Visual performance, safety, and patient satisfaction after binocular clear lens extraction and trifocal intraocular lens implantation in Chinese presbyopic patients.

BACKGROUND: Addressing presbyopia in the aging population, particularly in non-cataractous patients, remains a challenge. This study evaluates the outcomes of refractive lens exchange (RLE) with AT LISA tri 839MP trifocal intraocular lens (IOL) implantation in a Chinese presbyopic population without cataracts. METHODS: The study included 164 eyes from 82 patients undergoing bilateral RLE at Peking Union Medical College Hospital. Comprehensive evaluations encompassed visual acuities, refraction, ocular aberrometry, and subjective outcomes via the VF-14 questionnaire. The focus was on postoperative visual performance, refractive outcomes, safety, objective optical quality, and patient satisfaction. RESULTS: 100%, 90.2%, and 89.0% of patients achieved binocular UDVA, UNVA, and UIVA of logMAR 0.1 or better at 6 months postoperatively. 97.6% of eyes were within ± 1.00 D of emmetropia postoperatively. Optical quality assessments showed increases in modulation transfer function and Strehl ratios (p < 0.05). High-order aberrations decreased significantly (p < 0.05). Despite the high incidence of posterior capsule opacification (83.2%), managed with early Nd: YAG capsulotomy, no other severe complications were reported. Patient-reported outcomes indicated high satisfaction, with an average VF-14 score of 94.3 ± 10.2 and 93.5% achieving complete spectacle independence. Halo (66.2%) was the most commonly reported optical phenomena, followed by glare (18.2%), and starburst (7.8%) after surgery. CONCLUSIONS: Bilateral RLE with trifocal IOLs in presbyopic patients without cataracts significantly improves visual acuity and reduces ocular aberrations in presbyopic patients. The procedure offers high patient satisfaction and spectacle independence, though it requires careful patient selection and management of expectations regarding potential photic phenomena.

Changes in visual performance after implantation of different intraocular lenses.

AIM: To evaluate the trending visual performance of different intraocular lenses (IOLs) over time after implantation. METHODS: Ninety-one patients received cataract surgery with implantations of monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs, and extended-depth-of-focus (EDoF) IOLs were included. The aberrations and optical quality collected with iTrace and OQAS within postoperative 6mo were followed and compared. RESULTS: Most of the visual parameters improved over the postoperative 6mo. The postoperative visual acuity (POVA) of the Mon IOL, SegRef IOL, and EDoF IOL groups achieved relative stability in earlier states compared with the Dif IOL group. Nevertheless, the overall visual performance of the 3 IOLs continued to upturn in small extents within the postoperative 6mo. The optical quality initially improved in the EDoF IOL group, then in the Mon IOL, SegRef IOL, and Dif IOL groups. POVA and objective visual performance of the Mon IOL and EDoF IOL groups, as well as POVA and visual quality of the Dif IOL group, improved in the postoperative 1mo and stabilized. Within the postoperative 6mo, gradual improvements were observed in the visual acuity and objective visual performance of the SegRef IOL group, as well as in the postoperative optical quality of the Dif IOL group. CONCLUSION: The visual performance is different among eyes implanted with different IOLs. The findings of the current study provide a potential reference for ophthalmologists to choose suitable IOLs for cataract patients in a personalized solution.

A New Methodology for Evaluating the Potential Impact of Residual Refractive Astigmatism in Pseudophakic Patients.

Purpose: To validate a new methodology to evaluate the impact of astigmatism in pseudophakia using an astigmatic defocus curve. Setting: Hospital Oftalmológico de Brasilia, Brazil. Design: Non-randomized cohort study. Methods: For every point of the defocus curve, from -2.00 to +3.00 with 0.50D intervals, visual acuity was assessed with optically induced astigmatism (0.50D, 1.00D and 1.50D at 90 and 180 degrees) in pseudophakic patients implanted with a refractive-enhanced intraocular lens. Results: Twelve patients were analyzed. A statistically significant difference was found between the 90° (ATR) and 180°(WTR) axis with 1.50D astigmatism, providing better visual acuity in ATR astigmatism (p < 0.05). Conclusion: This new methodology is reproducible, useful and may predict residual astigmatism tolerance in pseudophakic patients, which may help with surgery planning and IOL decision-making.

Biometric factors associated with the postoperative visual performance of a multifocal intraocular lens.

Purpose: To identify the biometric factors associated with postoperative visual performance after uneventful phacoemulsification with multifocal intraocular lens (MIOL) implantation. Methods: In this retrospective cohort study, 72 eyes of 72 patients implanted with the HumanOptics Diff-aAY MIOL were included. Preoperative examination data including the white-to-white distance (WTW), anterior chamber depth (ACD), axial length and corneal astigmatism were gathered through the electronic medical records. One month postoperatively, the pupil parameters, corneal aberrations, corneal astigmatism, IOL tilts and IOL decentrations were measured using an OPD-Scan III aberrometer. Postoperative visual performance parameters were recorded as the visual acuity, depth of focus, modulation transfer function (MTF) and point spread function (PSF) values, area under log contrast sensitivity function (AULCSF), retinal straylight and visual function questionnaire scores. Univariate and multivariate linear regression analyses were then performed to evaluate the associations between the potential biometric factors and postoperative visual outcomes. Results: Younger age predicted greater MTF and PSF values, better AULCSF and better retinal straylight (P < 0.05). A lower corneal trefoil predicted better MTF and PSF values (P < 0.05). Smaller IOL decentration predicted better distance-corrected near visual acuity, greater AULCSF and better retinal straylight (P < 0.05). A less negative spherical equivalent (SE) predicted better MTF values (P = 0.017), while a more negative SE predicted better Visual Function Index-14 (VF-14) questionnaire scores and satisfaction scores (P < 0.05). A higher IOL power predicted better best corrected distance visual acuity (P = 0.005). Lower preoperative corneal astigmatism predicted greater MTF values (P = 0.020). Lower postoperative corneal astigmatism, smaller corneal high-order aberrations (HOAs), smaller photopic pupil size, larger WTW and deeper ACD predicted a better AULCSF (P < 0.05). Conclusions: IOL decentration, IOL power, age, preoperative and postoperative corneal astigmatism, SE, photopic pupil size, corneal trefoil, WTW, ACD and corneal HOAs were significantly associated with postoperative visual performance. These findings might aid in patient selection prior to MIOL implantation.

Evaluation of the effects of blue-enriched white light on cognitive performance, arousal, and overall appreciation of lighting.

Introduction: Light's non-visual effects on the biological clock, cognitive performance, alertness, and mental health are getting more recognized. These are primarily driven by blue light, which triggers specific retinal cells containing melanopsin. Traditionally, research on light has relied on correlated color temperature (CCT) as a metric of its biological influence, given that bluer light corresponds to higher Kelvin values. However, CCT proves to be an inadequate proxy of light's biological effects. A more precise metric is melanopic Equivalent Daylight Illuminance (mel-EDI), which aligns with melanopsin spectrum. Studies have reported positive cognitive impacts of blue-enriched white light. It's unclear if the mixed results are due to different mel-EDI levels since this factor wasn't assessed. Method: Given recent recommendations from experts to aim for at least 250 mel-EDI exposure daily for cognitive benefits, our aim was to assess if a 50-minute exposure to LED light with 250 mel-EDI could enhance concentration and alertness, without affecting visual performance or comfort compared to conventional lighting producing around 150 mel-EDI. To ensure mel-EDI's impact, photopic lux levels were kept constant across conditions. Conditions were counterbalanced, parameters included subjective sleepiness (KSS; Karolinska Sleepiness Scale), concentration (d2-R test), visual performance (FrACT; Freiburg Visual Acuity and Contrast Test), general appreciation (VAS; Visual Analogous Scale), preferences and comfort (modified OLS; Office Lighting Survey). Results: The experimental light significantly reduced sleepiness (p = 0.03, Cohen's d = 0.42) and also decreased contrast sensitivity (p = 0.01, Cohen's d = 0.50). The conventional light was found to be more comfortable (p = 0.002, Cohen's d = 0.62), cheerful (p = 0.02, Cohen's d = 0.46) and pleasant (p = 0.005, Cohen's d = 0.55) while the experimental light was perceived as brighter (p = 0.004, Cohen's d = 0.58) and tended to be more stimulating (p = 0.10). Notably, there was a preference for conventional lighting (p = 0.004, Cohen's d=0.56) and concentration was equally improved in both conditions. Discussion: Despite the lack of further improvement in concentration from exposure to blue-enriched light, given the observed benefits in terms of vigilance, further research over an extended period would be justified. These findings could subsequently motivate cognitive optimization through lighting for workers that would benefit from artificial lighting such as in northern regions.

Evaluation of eye-catching effect in highway tunnel entrance area based on saccade behavior.

OBJECTIVE: This study aimed to investigate the effects of visual attraction in the entrance areas of highway tunnels on drivers' saccade behavior and driving safety, with the objective of providing insights for tunnel entrance design and driver education. METHODS: Fifty participants were recruited for the naturalistic driving experiment. Four different visually attractive driving scenarios (baseline, landscape-style architecture, tip slogan, and billboard) were selected. Eye-tracking technology was utilized to record and analyze the scanning behavior of participating drivers. Various metrics, including saccade duration, frequency, amplitude, velocity, and the peak-to-average ratio of saccade velocity (PARSV), were measured and compared across different scenarios. RESULTS: The results revealed different patterns of visual scanning dynamics among the four experimental scenarios, reflecting the different levels of visual-cognitive demands and situation awareness of drivers. The visual attraction in the tunnel entrance area resulted in prolonged saccade duration, increased saccade amplitude, reduced saccade frequency, and slower, less stable saccade velocity. Among these, drivers exhibited the most intricate and unstable scanning behavior, accompanied by the lowest level of situational awareness, particularly under the influence of visual attraction of tip slogan. CONCLUSIONS: The findings highlight the importance of considering visual attraction in tunnel entrance design. Minimizing unnecessary visual attraction can help reduce distractions and maintain driver attention, ultimately enhancing driving safety. Driver education programs should emphasize the significance of adapting to visual attraction at tunnel entrances to promote safer driving practices. Overall, this study contributes valuable insights into the effects of visual attraction on driver scanning behavior, facilitating the development of strategies to improve tunnel design and driver education.

Association between functional network connectivity, retina structure and microvasculature, and visual performance in patients after thalamic stroke: An exploratory multi-modality study.

BACKGROUND AND OBJECTIVE: Neuro-ophthalmologic symptoms and retinal changes have been increasingly observed following thalamic stroke, and there is mounting evidence indicating distinct alterations occurring in the vision-related functional network. However, the intrinsic correlations between these changes are not yet fully understood. Our objective was to explore the altered patterns of functional network connectivity and retina parameters, and their correlations with visual performance in patients with thalamic stroke. METHODS: We utilized resting-state functional MRI to obtain multi-modular functional connectivity (FC), and optical coherence tomography-angiography to measure various retina parameters, such as the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), superficial vascular complex (SVC), and deep vascular complex. Visual acuity (VA) was used as a metric for visual performance. RESULTS: We included 46 patients with first-ever unilateral thalamic stroke (mean age 59.74 ± 10.02 years, 33 males). Significant associations were found between FC of attention-to-default mode and SVC, RNFL, and GCIPL, as well as between FC of attention-to-visual and RNFL (p < .05). Both RNFL and GCIPL exhibited significant associations with FC of visual-to-visual (p < .05). Only GCIPL showed an association with VA (p = .038). Stratified analysis based on a disease duration of 6 months revealed distinct and significant linking patterns in multi-modular FC and specific retina parameters, with varying correlations with VA in each subgroup. CONCLUSION: These findings provide valuable insight into the neural basis of the associations between brain network dysfunction and impaired visual performance in patients with thalamic stroke. Our novel findings have the potential to inform future targeted and individualized therapies. However, further comprehensive studies are necessary to validate our results.

Safety, Efficacy, and Visual Performance of an Orthokeratology Lens with Increased Compression Factor.

The aim was to evaluate the safety, efficacy, and visual performance of an orthokeratology lens with an increased compression factor (ICF) of 1.25 D in a 3-month follow-up. Thirty-six myopic patients (5 males and 31 females; 24.2 ± 5.8 years) were fitted with Alexa AR (Tiedra Farmacéutica S.L., Madrid, Spain) contact lenses (CLs) and twenty participants finished the follow-up. Visual acuity (VA), subjective refraction, primary spherical and primary coma aberrations, keratometry, central pachymetry, and ocular surface evaluation were performed at baseline and after 1 night, 1 week, 1 month, and 3 months of CL wear. The differences among visits were analyzed using a repeated-measures analysis of variance or the Friedman test. The spherical equivalent decreased (p ≤ 0.005), and the uncorrected VA improved (p < 0.001) until the first week. Corneal and ocular aberrations showed a significant increase (p ≤ 0.02). A significant decrease (p < 0.001) was found for keratometry values. No significant changes were observed in either central pachymetry or ocular surface parameters among study visits. In conclusion, an orthokeratology CL with an ICF of 1.25 D provides good safety, efficacy, and visual performance in a 3-month follow-up. Seven days of orthokeratology wear are enough to achieve the full myopic compensation, resulting in satisfactory VA.

Do microsaccades vary with discriminability around the visual field?

Microsaccades-tiny fixational eye movements- improve discriminability in high acuity tasks in the foveola. To investigate whether they help compensate for low discriminability at perifovea, we examined MS characteristics relative to the adult visual performance field, which is characterized by two perceptual asymmetries: Horizontal-Vertical Anisotropy (better discrimination along the horizontal than vertical meridian), and Vertical Meridian Asymmetry (better discrimination along the lower- than upper-vertical meridian). We investigated whether and to what extent microsaccade directionality varies when stimuli are at isoeccentric locations along the cardinals under conditions of heterogeneous discriminability (Experiment 1) and homogeneous discriminability, equated by adjusting stimulus contrast (Experiment 2). Participants performed a two-alternative forced-choice orientation discrimination task. In both experiments, performance was better on trials without microsaccades between ready signal onset and stimulus offset than on trials with microsaccades. Across the trial sequence the microsaccade rate and directional pattern were similar across locations. Our results indicate that microsaccades were similar regardless of stimulus discriminability and target location, except during the response period-once the stimuli were no longer present and target location no longer uncertain-when microsaccades were biased toward the target location. Thus, this study reveals that microsaccades do not flexibly adapt as a function of varying discriminability in a basic visual task around the visual field.

Effect of myopia-control lenses on central and peripheral visual performance in myopic children.

PURPOSE: To evaluate the short-term effects of three myopia-control lenses, which impose peripheral myopic defocus while providing clear central vision, on central and peripheral visual performance in myopic children. METHODS: Twenty-one myopic children were enrolled in the study. Central visual performance was assessed using the quick contrast sensitivity function. Peripheral visual performance was evaluated by measuring peripheral contrast threshold and global motion perception, while subjects maintained fixation through the central portion of the lens. Single-vision spectacle lenses (SVL), spectacle lenses with highly aspherical lenslets (HAL) and defocus-incorporated soft contact (DISC) lenses were evaluated in random order, followed by orthokeratology (OK) lenses. All tests were performed monocularly on the right eye. RESULTS: The area under the log contrast sensitivity function (AULCSF) with DISC lenses was lower than that with SVL (1.14 vs. 1.40, p < 0.001) and HAL (1.14 vs. 1.33, p = 0.001). HAL increased the temporal visual field contrast threshold compared with OK lenses (p = 0.04), and OK lenses decreased the superior visual field contrast threshold compared with that of SVL (p = 0.04) and HAL (p = 0.005). HAL also increased the peripheral coherence threshold for identifying the contraction movement compared with OK lenses (p = 0.01). CONCLUSIONS: The short-term use of these optical interventions for myopia control exhibited measurable differences in central and peripheral visual performance. Relevant attention could be paid to these differences, especially when children switch to different treatments. DISC lenses exhibited worse central contrast sensitivity than SVL and HAL. Imposing peripheral defocus signals did not affect children's peripheral visual performance compared with SVL. However, considering the poorer peripheral visual performance provided by HAL, OK lenses are recommended for children if there are specific demands for global scene recognition and motion perception.

Visual quality assessment and comparison of two multifocal scleral lens designs.

PURPOSE: To analyze the visual quality of a new multifocal scleral lens with a customized decentred optic zone compared to a conventional design by measuring visual acuity, contrast sensitivity function, stereopsis, subjective vision and comfort after one month of wear. METHODS: Nineteen presbyopic subjects were fitted with two multifocal scleral lens designs: a conventional multifocal and a customized decentred optical zone design. All subjects wore both scleral lens designs for one month with a two-week washout period. The main variables evaluated included high and low-contrast visual acuity under photopic and mesopic light conditions, binocular defocus curves, contrast sensitivity function and a visual analogue scale (VAS) for subjective vision and comfort. RESULTS: Comparing the two scleral lens designs, statistically significant differences in visual acuity were found, highlighting the improvement in more than one chart line (6 letters) for low contrast near tests under photopic light conditions with the decentred optics lens design. VAS questionnaire scores also showed a significant improvement in distance and overall subjective vision with the decentred optics lenses. Contrast sensitivity function showed an improvement with decentred multifocal lenses at all spatial frequencies measured, being statistically significant for 12 cycles per degree. No differences in stereoacuity were found. CONCLUSION: Multifocal scleral lenses with a customized decentred optical zone proved to be a promising refractive correction in presbyopic subjects after one month of wear, offering good comfort and visual quality under photopic and mesopic light conditions.

The evaluation of eye-catching effect in freeway tunnel entrance zone based on fixation behavior characteristics.

OBJECTIVE: The visual attraction of the freeway tunnel entrance zone will affect the driver's visual performance and visual workload, and then affect the driving safety. The purpose of this study is to explore the influence of different visual attraction conditions in the entrance zone of the freeway tunnel on driver's fixation behavior, and then evaluate the impact of eye-catching effect on driving safety. METHODS: Thirty-five participants were recruited for the naturalistic driving experiment. Four different visually attractive driving scenarios (baseline, landscape-style architecture, tip slogan, and billboard) were selected. Participants' fixation behavior data were collected using an eye-tracking device. The effects of the visual attraction conditions in the freeway tunnel entrance zones were analyzed on driver fixation duration, number of fixations, fixation deviation, and pupil diameter. RESULTS: The results demonstrated significant effects of different visual attractions in the entrance zone of the freeway tunnel on drivers' fixation behavior. Under the visual attraction of the billboard, drivers exhibited the most number of fixations. And under the visual attraction of tip slogan, drivers had the longest average fixation duration, the smallest horizontal fixation deviation, the largest vertical fixation deviation, and the highest pupil diameter and its coefficient of variation. CONCLUSIONS: It can be concluded that different visual attractions in the freeway tunnel entrance zone have different effects on the eye-catching effect of drivers, by influencing the fixation behavior characteristics of drivers. Billboard is most effective in capturing drivers' visual attention, and tip slogan requires greater attention allocation and visual cognitive effort from drivers, resulting in the highest visual cognitive workload. This study highlights the complex relationship between visual attraction and its performance on driver fixation behavior. The insights from this study can provide valuable references for the design and optimization of the visual environment in the entrance zone of freeway tunnels.

Influence of lighting on visual performance

ABSTRACT Purpose: This review emphasizes the effect of light on visual efficiency, the impact of different lighting focuses, types of lighting, and their influence on vision and productivity. Light sources and standards are intriguing subjects for ophthalmologists. Guidelines regarding the level of lighting influence on visual activities can enhance visual performance.Methods: This article was developed based on literature reviews, with a bibliographic survey conducted in databases such as PubMed, MEDLINE, Web of Science, Embase, LILACS, and SciELO. Results: Provides recommendations for understanding information regarding the influence of lighting on visual performance. Conclusion: Proper workplace lighting is crucial for improving visual efficiency, safety, productivity, and worker health. Efficient workplace lighting should avoid light sources directed towards the worker's face, prevent harmful glare, be more intense in the work area, and uniform in the rest of the room. Ophthalmologists should be knowledgeable about and provide guidance on correct lighting to ensure patient comfort and satisfaction with visual correction.

The Role of Early Nd:YAG Laser Capsulotomy in Improving Visual Performance in Mild to Moderately Symptomatic Trifocal Patients.

Purpose: To determine the effect of early Nd:YAG (neodymium:yttrium-aluminum-garnet) laser capsulotomy on objective and subjective visual quality in symptomatic trifocal intraocular lens (IOL) patients. Methods: A single-center, prospective study examined symptomatic patients after bilateral cataract extraction with trifocal IOL implantation. A ten-question survey was conducted one month after surgery. Study endpoints included the assessment of monocular and binocular uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), contrast sensitivity (CS), and subjective visual quality before and after Nd:YAG capsulotomy prior to 4 months after cataract surgery. Results: A total of 38 eyes from 21 patients were included with a TFAT00 (n = 23) or TFAT30-60 (n = 15). Overall satisfaction with the IOL was 8.55 ± 1.77 (range 5-10). A Nd:YAG capsulotomy was performed at 55 ± 26 days. Monocular UDVA and UNVA > 20/25 before Nd:YAG were 53.0% and 42.0%, which improved post-Nd:YAG to 63.0% and 66.0%, respectively (P = 0.41, P = 0.051). Binocular UDVA and UNVA >20/25 before Nd:YAG were 82.0% and 63.0%, which increased to 97% and 97%, respectively (P < 0.05, P < 0.001). CS increased in all post-Nd:YAG capsulotomies (P < 0.01). The presence of glare was documented at 74% pre-Nd:YAG, which decreased to 41% post-Nd:YAG (P < 0.01). Glare which limited activities was documented at 24%, which decreased to 5% post-Nd:YAG (P = 0.21). Conclusion: Early treatment of posterior capsule opacities in mild to moderately dissatisfied trifocal IOL patients may be beneficial in improving CS, visual quality, and reducing the presence and severity of dysphotopsias.

Corneal Edema after Cataract Surgery.

This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms.

Comparison of visual performance with iTrace analyzer following femtosecond laser-assisted cataract surgery with bilateral implantation of two different trifocal intraocular lenses.

AIM: To compare the postoperative binocular visual performance with an iTrace analyzer following femtosecond laser-assisted cataract surgery (FLACS) combined with bilateral implantation of two different types of diffractive trifocal intraocular lenses (IOL). METHODS: During this retrospective observational study, patients who received bilateral FLACS combined with implantation of two different types of diffractive trifocal IOLs were evaluated. According to the IOLs' different types and design, the patients were divided into AT LISA tri839MP group (tri839 group) and AcrySof PanOptix TFNT00 group (TFNT group). Study parameters included preoperative and postoperative uncorrected distance visual acuity (UDVA) at 5 m, uncorrected near visual acuity (UNVA) at 30 cm and 40 cm, uncorrected intermediate visual acuity (UIVA) at 60 cm and 80 cm, postoperative refractive status, objective visual qualities and total high order aberrations (HOAs) postoperatively. The postoperative complications were also recorded. RESULTS: Totally 56 eyes of 28 patients (tri839 group, n=26; TFNT group, n=30) were included. Preoperative baseline characteristics between groups were not statistically significantly different. UDVA was not significantly different between groups except for 1wk follow-up due to the postoperative corneal edema. TFNT group showed statistically significant better UNIA at 60 cm than tri839 group at the 1wk (0.05±0.19 vs 0.15±0.10 logMAR, P=0.013), 1mo (0.05±0.12 vs 0.15±0.09 logMAR, P=0.001) and 3mo (0.04±0.12 vs 0.15±0.11 logMAR, P=0.001) follow-up, while tri839 group showed statistically significant better UNIA at 80 cm than TFNT group at the 1d (0.14±0.15 vs 0.20±0.14 logMAR, P=0.041) and 1mo (0.09±0.07 vs 0.14±0.10 logMAR, P=0.042) follow-up. Postoperative refractive status showed stable at every visit. Modulated transfer function (MTF) values and strehl ratio (SR) values were improved and HOAs were lower significantly after surgery. CONCLUSION: FLACS with bilateral implantations of both tri839 and TFNT00 can achieve satisfactory natural whole-course vision, high postoperative refractive stability and good visual quality but without significantly difference. iTrace aberration instrument can accurately evaluate the visual quality under different status.

Maximal incremental exercise improves macular photostress recovery time and lowers intraocular pressure in healthy athletes.

OBJECTIVES: Better visual performance in athletes compared to non-athletes could suggest improved macular function through physical exertion. The study aimed to investigate the effect of maximal incremental treadmill (MIT) exercise on macular function. DESIGN: An interventional study comparing the effect of maximal incremental treadmill (MIT) exercise until volitional exhaustion between athletes (n = 26) and non-athletes (n = 26). METHODS: Participants underwent an ophthalmological assessment involving repeated measurements of the photostress recovery time (PSRT) at baseline and post-exercise. PSRT was recorded after a 10-second exposure of the macular to an intense light source from an ophthalmoscope positioned 2 cm in front of the eye. Secondary outcome measures also recorded included the best-corrected visual acuity (BCVA) and the intraocular pressure (IOP). RESULTS: Compared to the baseline, MIT exercise markedly improved the PSRT of athletes from 42.7 ±â€¯1.6 s to 39.6 ±â€¯1.4 s (P < 0.001), while having no significant changes in the PSRT of non-athletes. After adjusting for exercise duration, the exercise intervention showed significant effects on the PSRT improvement in the athletes compared to non-athletes after exercise [F(1,49) = 16.941, P < 0.001], with estimated marginal means of 3.00 s and 0.47 s, respectively. Also, the exercise intervention resulted in significant improvements in IOP (P < 0.001) and BCVA (P < 0.01) of both groups. CONCLUSIONS: MIT exercise improves macular function, BCVA, and reduced IOP in healthy athletes. Maximal incremental exercise may be recommended for competitive sports athletes seeking optimal visual performance, as long as it does not adversely impact other relevant non-visual factors.

Oral fructose intake does not improve exercise, visual, or cognitive performance during acute normobaric hypoxia in healthy humans.

Introduction: The ability to metabolize fructose to bypass the glucose pathway in near-anaerobic conditions appears to contribute to the extreme hypoxia tolerance of the naked-mole rats. Therefore, we hypothesized that exogenous fructose could improve endurance capacity and cognitive performance in humans exposed to hypoxia. Methods: In a randomized, double-blind, crossover study, 26 healthy adults (9 women, 17 men; 28.8 ± 8.1 (SD) years) ingested 75 g fructose, 82.5 g glucose, or placebo during acute hypoxia exposure (13% oxygen in a normobaric hypoxia chamber, corresponding to oxygen partial pressure at altitude of ~3,800 m) on separate days. We measured exercise duration, heart rate, SpO2, blood gasses, and perceived exertion during a 30-min incremental load test followed by Farnsworth-Munsell 100 Hue (FM-100) color vision testing and the unstable tracking task (UTT) to probe eye-hand coordination performance. Results: Exercise duration in hypoxia was 21.13 ± 0.29 (SEM) min on fructose, 21.35 ± 0.29 min on glucose, and 21.35 ± 0.29 min on placebo (p = 0.86). Heart rate responses and perceived exertion did not differ between treatments. Total error score (TES) during the FM-100 was 47.1 ± 8.0 on fructose, 45.6 ± 7.6 on glucose and 53.3 ± 9.6 on placebo (p = 0.35) and root mean square error (RMSE) during the UTT was 15.1 ± 1.0, 15.1 ± 1.0 and 15.3 ± 0.9 (p = 0.87). Discussion: We conclude that oral fructose intake in non-acclimatized healthy humans does not acutely improve exercise performance and cognitive performance during moderate hypoxia. Thus, hypoxia tolerance in naked mole-rats resulting from oxygen-conserving fructose utilization, cannot be easily reproduced in humans.