Climate-associated variation in the drivers of benthic macroinvertebrate species-area relationships across shallow freshwater lakes.

The island species-area relationship (ISAR) describes how species richness increases with increasing area of a given island or island-like habitat, such as freshwater lakes. While the ISAR is one of the most common phenomena observed in ecology, there is variation in both the form of the relationship and its underlying mechanisms. We compiled a global data set of benthic macroinvertebrates from 524 shallow freshwater lakes, ranging from 1 to 293,300 ha in area. We used individual-based rarefaction to determine the degree to which ISAR was influenced by mechanisms other than passive sampling (larger islands passively sample more individuals from the regional pool and, therefore, have more species than smaller islands), which would bias results away from expected relationships between rarefied species richness (and other measures that capture relative abundances) and lake area. We also examined how climate may alter the shape of the ISARs. We found that both rarefied species richness (the number of species standardized by area or number of individuals) and a measure of evenness emphasizing common species exhibit shallow slopes in relationships with lake area, suggesting that the expected ISARs in these lakes most likely result from passive sampling. While there was considerable variation among ISARs across the investigated lakes, we found an overall positive rarefied ISAR for lakes in warm (i.e. tropical/subtropical) regions (n = 195), and in contrast, an overall negative rarefied ISAR in cool (i.e. north temperate) lakes (n = 329). This suggested that mechanisms beyond passive sampling (e.g. colonization-extinction dynamics and/or heterogeneity) were more likely to operate in warm lakes. One possible reason for this difference is that the area-dependent intensity of fish predation, which can lead to flatter ISARs, is weaker in warmer relative to cooler lakes. Our study illustrates the importance of understanding both the pattern and potential processes underlying the ISARs of freshwater lakes in different climatic regions. Furthermore, it provides a baseline for understanding how further changes to the ecosystem (i.e. in lake area or climate) might influence biodiversity patterns.

Food web differences between two neighboring tropical high mountain lakes and the influence of introducing a new top predator.

High mountain lakes (HMLs) are considered unique and comparable ecosystems for monitoring global climate change. The food web structure can indicate the response of these ecosystems to ecological threats, such as fish introduction, by analyzing the trophic dynamics. Nonetheless, the food webs of tropical HMLs are less well-studied than temperate HMLs. The present study assessed the food webs of two neighboring (600 m apart) tropical HMLs, El Sol and La Luna, inside the crater of the Nevado de Toluca volcano, Mexico. It used stable isotopes (δ13C and δ15N) and Bayesian mixing models with different trophic discrimination factors and priors to assess the impacts of introduced rainbow trout, persisting only in the larger lake, El Sol. The food web in Lake El Sol was more complex than in Lake La Luna, mainly due to its larger size, extensive vegetated littoral zone, and being fueled by autochthonous primary production. In contrast, the smaller and fishless Lake La Luna has a reduced and bare littoral zone that harbored a simple food web substantially sustained by allochthonous carbon inputs. The persistence of introduced rainbow trout in Lake El Sol but not in Lake La Luna accentuated the differences between the lakes. The models suggested that rainbow trout fed on key consumers of littoral macroinvertebrates (70-80%) and pelagic zooplankton (20-30%), increasing the linkage between sub-networks. In both tropical HMLs, the species richness and herbivorous fraction were elevated compared with temperate HMLs, while the linkage density and omnivorous fraction were lower. Basal nodes dominated these tropical HMLs, and the vegetated littoral zone of Lake El Sol had more intermediate (omnivore) nodes. Our results showed the convenience of food web analysis to compare the effects of introduced fish in originally fishless lakes in different latitudes.

Visual Performance of Eyes with Residual Refractive Errors after Implantation of an Extended Vision Intraocular Lens.

Background: To analyze the tolerance on distance vision of different combined residual astigmatic situations in patients implanted with a novel wavefront shaping extended depth of focus (EDoF) intraocular lens (IOL). Methods: The study included patients implanted with the Acrysof® IQ Vivity® IOL. Uncorrected (UDVA) and corrected distance visual acuity (CDVA) were measured three months after surgery, considering CDVA as the reference situation of the study. Distance VA was also measured in different refractive situations: (A) with 0.50 diopters (D) of positive (myopization) and negative (hyperopization) defocus and (B) with a residual mixed astigmatic refraction induced by adding a combination of -0.25 D spherical and 0.50 D cylindrical lenses placed in vertical (against the rule-ATR), oblique, and horizontal (with the rule-WTR) positions. Results: The study included 30 eyes of 30 patients. UDVA and CDVA were -0.04 ± 0.05 and -0.05 ± 0.05 logMAR, respectively. VA values with +0.50 D and -0.50 D of defocus were 0.01 ± 0.06 and 0.00 ± 0.04 logMAR, respectively. VA was better with distance correction (p < 0.001) and no differences were found between the myopic and the hyperopic situations (p=0.09). Distance VA for the ATR, oblique, and WTR astigmatic situations was 0.01 ± 0.05, 0.01 ± 0.06, and 0.01 ± 0.04 logMAR, respectively. VA was better for the reference situation (p < 0.001) and no differences were found among the three astigmatic situations (p=0.21). Conclusions: Low residual defocus and mixed astigmatic errors, regardless of its orientation, seem to be tolerated by patients implanted with the studied EDoF IOL. This trial is registered with NCT05392998. Registered 26 May 2022-Retrospectively registered.

Visual performance and impact of residual refractive errors with trifocal intraocular lenses of different aspheric design.

BACKGROUND: To assess the visual quality and the tolerance to low refractive errors of two trifocal intraocular lenses (IOL) with different amounts of spherical aberration (SA). METHODS: The study included patients having bilateral implantation of the AcrySof® IQ PanOptixTM (aberration-correcting) or the RayOneTM (aberration-free) Trifocal IOL. Three months after the surgery patients underwent: monocular/binocular and uncorrected/corrected distance visual acuity (VA) and binocular defocus curves. Binocular contrast sensitivity (CSF) and subjective halo perception were assessed with the best distance correction (CDVA), with a positive defocus of + 0.50D and with a negative defocus of -0.50D. Patient's satisfaction was evaluated with the Catquest9-SF questionnaire. RESULTS: This study included 54 eyes (28 with PanOptix and 26 with RayOne) of 27 patients. Both groups achieved corrected/uncorrected and monocular/binocular distance VA values better than 0.0 logMAR (1.0 decimal) with no statistically significant differences between them (p > 0.05 for all cases). Defocus curves showed a VA of 0.1 logMAR or better between -2.5 and + 1.0D with no differences between groups (p > 0.05 at all distances). Overall CSF values remained stable under the induced residual refractions for both groups. The halo effect remained stable for the PanOptix group but increased with myopization in the RayOne group (p = 0.02). The questionnaire showed high rates of patient's satisfaction with no differences between groups. CONCLUSION: Both lenses showed overall good visual outcomes and offered high rates of patient's satisfaction. Moreover, in normal patients with trifocal IOLs, the combination of residual refractive errors and certain amounts of SA may increase some visual disturbances.

Shifts in water column microbial composition associated to lakes with different trophic conditions: "Lagunas de Montebello" National Park, Chiapas, México.

Eutrophication is a global problem causing the reduction of water quality and the loss of ecosystem goods and services. The lakes of the "Lagunas de Montebello" National Park (LMNP), Chiapas, Mexico, not only represent unique and beautiful natural scenic sites in southern Mexico but are also a national protected area and RAMSAR site. Unfortunately, some of these lakes started showing eutrophication signs since 2003. Anthropogenic activities (e.g., land-use change from forested to agricultural and urban development) are leading to water quality and trophic state alterations of the lakes of the LMNP. This study shows the results of a coupled limnological characterization and high-throughput sequencing of the V4 hypervariable region of the 16S rRNA gene to analyze the microbial composition of the water column in a set of oligotrophic and eutrophic lakes. Chlorophyll a (Chl-a) was the main environmental parameter correlated with the trophic conditions of the lakes. Although the microbial diversity was similar, the microbial composition changed significantly from oligo to eutrophic lakes. Proteobacteria, Firmicutes, and Cyanobacteria were the main components of oligotrophic lakes, and Cyanobacteria, Proteobacteria, and Bacteroidetes of eutrophic lakes. While Acinetobacter (Proteobacteria) and Cyanobium (a unicellular cyanobacterium) dominated in oligotrophic lakes, the filamentous, bloom-forming, and toxin-producing cyanobacteria Planktothrix was the dominant genus in eutrophic lakes. High-throughput sequencing allowed the detection of changes in the composition of the microbial component in oligotrophic lakes, suggesting a shift towards eutrophication, highlighting the relevance of sensitive monitoring protocols of these ecosystems to implement remediation programs for eutrophicated lakes and conservation strategies for those yet pristine.

Impacts of global change on two tropical, high mountain lakes in Central Mexico.

High mountain lakes and their catchments are remote ecosystems in areas with low anthropogenic disturbance. High mountain lakes integrate changes in the atmosphere and catchment areas (e.g., acid rain, airborne pollutants, climate change). The present research analyses long-term datasets of meteorological and limnological variables representing two tropical high mountain lakes, El Sol and La Luna, in Central Mexico to identify the impacts of anthropogenic disturbance (i.e., sentinels of global/climate change). The 54-year meteorological analysis showed marked interannual variability with no statistically significant air temperature or rainfall trends. However, from 2000 to 2018, the air temperature increased by 0.5 °C. Accordingly, the lake water temperature increased (Lake El Sol: 0.8 °C, Lake La Luna: 0.6 °C). Although the rainfall displayed no change, the water level decreased in both lakes (1.5 m), most likely associated with increased evapotranspiration. Unexpectedly, the dissolved inorganic nitrogen (DIN) concentration in the lakes decreased. The initial acid pH rose to close neutrality in Lake La Luna and to alkaline values in Lake El Sol. The latter may be a consequence of the lowered SOx and NOx emissions from governmental regulations promulgated to control atmospheric pollution beginning in 2000 and probably resulting in less acidic deposition. An additional explanation for the lakes' deacidification is the increased deposition of alkaline ions derived from activities at the volcano slopes. Since the atmospheric supply is the primary nitrogen source to high mountain lakes, the DIN concentration decline could reflect the reduction in atmospheric HNO3. Thus, Lakes El Sol and La Luna evidenced global change. Both lakes are inside the same crater and are subjected to similar influences; thus, they showed similar responses to global change (increasing lake water temperatures, declining water levels, higher pH value, and lower DIN concentrations). Nevertheless, their differences (e.g., catchment size, surface area, water volume, water depth, trophic status) influenced the magnitude of the impacts, with higher pH increases recorded in Lake El Sol and higher DIN concentrations in Lake La Luna.

Patient Satisfaction and Visual Performance in Patients with Ocular Pathology after Bilateral Implantation of a New Extended Depth of Focus Intraocular Lens.

Aim: To evaluate visual results and patient-perceived outcomes in patients with ocular pathologies implanted with a new extended depth-of-focus intraocular lens (IOL). Methods: Patients with ocular pathology undergoing cataract surgery and bilaterally implanted with Vivity® IOLs were evaluated three months after surgery. The control group included patients with no ocular pathologies. Binocular defocus curves, corrected and uncorrected mono- and binocular distance visual acuity (DVA), and binocular contrast sensitivity were measured. Patients completed the Catquest-9SF questionnaire and reported on dysphotopsia and their need for spectacle-correction. Results: Twenty-five patients were included in each group. Monocular uncorrected DVA was better in the control group (-0.01 ± 0.07) compared with the study group (0.03 ± 0.08), p=0.027. There were no other statistically significant differences in DVA, with an uncorrected binocular acuity of -0.06 ± 0.06 for the control group and -0.05 ± 0.06 for the study group. Binocular defocus curves were similar for both groups and there were no differences in contrast sensitivity values. Pooling the refractive results, 96% of eyes were within ±0.50 D of target refraction. Seventy percent of patients in the control group reported no halos, compared with 40% in the study group, p=0.047. In both groups, 40% of patients reported being completely spectacle-independent, with the other 60% requiring glasses for near vision always or often. All patients reported being fairly or very satisfied with their vision. Conclusion: Initial results of visual function after Vivity implantation in patients with ocular pathologies are encouraging, with high patient satisfaction and few difficulties for daily activities.

Neutrophils and neutrophil extracellular trap components: Emerging biomarkers and therapeutic targets for age-related eye diseases.

Age-related eye diseases, including dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy, represent a major global health issue based on their increasing prevalence and disabling action. Unraveling the molecular mechanisms underlying these diseases will provide novel opportunities to reduce the burden of age-related eye diseases and improve eye health, contributing to sustainable development goals achievement. The impairment of neutrophil extracellular traps formation/degradation processes seems to be one of these mechanisms. These traps formed by a meshwork of DNA and neutrophil cytosolic granule proteins may exacerbate the inflammatory response promoting chronic inflammation, a pivotal cause of age-related diseases. In this review, we describe current findings that suggest the role of neutrophils and their traps in the pathogenesis of the above-mentioned age-related eye diseases. Furthermore, we discuss why these cells and their constituents could be biomarkers and therapeutic targets for dry eye, glaucoma, age-related macular degeneration, and diabetic retinopathy. We also examine the therapeutic potential of some neutrophil function modulators and provide several recommendations for future research in age-related eye diseases.

Effect of defocus combined with rotation on the optical performance of trifocal toric IOLs.

PURPOSE: To objectively analyze the optical quality of the FineVision Toric intraocular lens (IOL) with two cylinder powers when different combinations of rotations and residual refractive errors are induced. METHODS: This study assessed the FineVision Toric IOL with two different cylinder powers: 1.5 and 3.0 diopters (D). Three different rotation positions were considered: centered, 5° and 10° rotated. An optical bench (PMTF) was used for optical analysis. The optical quality of the IOLs was calculated by the modulation transfer function (MTF) at five different focal points (0.0, 0.25, 0.50, 0.75, and 1.00 D). RESULTS: The MTF averaged value of the reference situation was 38.58 and 37.74 for 1.5 and 3.0 D of cylinder, respectively. For the 1.5 D cylinder, the combination of 5° of rotation with a defocus of 0.25, 0.50, 0.75, and 1.0 D induced a decrease on the MTF of 12.39, 19.94, 23.43, 24.23 units, respectively. When induced rotation was 10°, the MTF decrease was 17.26, 23.40, 24.33, 24.48 units, respectively. For the 3.0 D cylinder, the combination of 5° with 0.25, 0.50, 0.75, and 1.0 D of defocus, induced a decrease on the MTF of 12.51, 18.97, 22.36, 22.48 units, respectively. When induced rotation was 10°, the MTF decrease was: 18.42, 21.57, 23.08, and 23.61 units, respectively. CONCLUSION: For both FineVision Toric IOLs there is a certain optical tolerance to rotations up to 5° or residual refractive errors up to 0.25 D. Situations over these limits and their combination would affect the visual quality of patients implanted with these trifocal toric IOLs.

Effect of residual astigmatism and defocus in eyes with trifocal intraocular lenses.

PURPOSE: To assess the effect on visual function of different residual astigmatic situations combined with 0.50 diopters (D) negative defocus at different distances in patients with trifocal intraocular lenses (IOLs). SETTING: Clínica Rementería, Madrid, Spain. DESIGN: Prospective case series. METHODS: The study included patients implanted with AcrySof IQ PanOptix IOL. Visual acuity (VA) was measured at far distance (0.00 D of vergence) and at -1.5 D, -2.5 D, and -3.0 D of vergence. Residual astigmatism was induced by adding 0.50 D and 1.00 D cylindrical lenses placed at 90 degrees (against the rule [ATR]), 45 degrees (oblique), and 180 degrees (with the rule). All measurements were made with distance correction (emmetropia as the reference situation) and with a simulated residual myopia of 0.50 D. RESULTS: The study included 61 eyes of 61 patients. Residual astigmatism of 0.50 D and 1.0 D was induced in 28 and 33 eyes, respectively. For both groups, distance and intermediate VAs were better for the reference situation (P < .001 for all cases). With 1.0 D of cylinder (without and with induced defocus), the proportion of patients who lost ≥2 lines was higher for the ATR astigmatism. For near vision, differences were smaller for all simulated situations. CONCLUSIONS: Residual astigmatism of up to 0.50 D, regardless of its orientation, seems to be tolerated at all distances. For astigmatisms of 1.0 D, distance and intermediate VAs decreased significantly, and ATR orientations showed worse results in a higher proportion of patients. The combination of astigmatism with residual myopia significantly decreased distance VA, whereas this negative shift affected near VA less.

Changes in Optical Quality Induced by Tilt and Decentration of a Trifocal IOL and a Novel Extended Depth of Focus IOL in Eyes With Corneal Myopic Ablations.

PURPOSE: To assess the effect of decentration and tilt combined with prior myopic ablations on the optical performance of a trifocal intraocular lens (IOL) and a novel IOL with an extended depth of focus (EDOF) design. METHODS: The XACT Mono-EDOF ME4 (Santen Pharmaceutical Co Ltd) and the trifocal FineVision (PhysIOL) IOLs were analyzed with and without simulated previous myopic ablations. The optical quality of the IOLs was evaluated with the PMTF optical bench (LAMBDA-X). The through-focus modulation transfer function (MTF) curves were recorded. Measurements were done for three situations: centered, 0.4 mm decentered, and 4 degrees tilted. RESULTS: The trifocal IOL showed three peaks of vision and the EDOF IOL showed a far distance peak with intermediate addition. When decentration or tilt were induced, the trifocal IOL showed negligible changes but the EDOF IOL showed a -0.50 diopters (D) shift of the overall curve. With simulated myopic ablation, the trifocal IOL showed a -0.50 D shift of the curve. When tilt or decentration were also induced, the better optical results were found at -1.00 D. With myopic ablations, the EDOF IOL showed a -0.50 D shift of the optical quality and when decentration or tilt were then induced, negative shifts over -1.00 D were found. CONCLUSIONS: The trifocal IOL was less affected by mis-alignments. When myopic ablations were induced, both lenses decreased their optical quality and the effects of misalignments were higher. In patients who have undergone corneal myopic ablation procedures, proper alignment of the implanted IOL and obtaining effective emmetropia becomes even more critical. [J Refract Surg. 2021;37(8):532-537.].

An Evaluation of the Agreement Between a Computerized Stereoscopic Game Test and the TNO Stereoacuity Test.

PURPOSE: Stereo-anomaly is commonly associated with amblyopia. An investigation was conducted to determine whether the measurements of stereoacuity obtained with the stereoacuity reference test (TNO Test) show an agreement with a computer stereoscope video game. METHODS: Thirty-two subjects (mean age 9.37±2.00 years) with an amblyopia history were selected for a blind and randomized study of stereoacuity improvement through a new random dot game. A masked examiner measured the stereoacuity three times per subject using the TNO test (at the beginning, at the end and after 6 months of the treatment). A second masked examiner measured stereoacuity using the new computerized game after the TNO masked evaluation. RESULTS: The Pearson's correlation coefficient one test against the other was r2 = 0.767 and the Bland-Altman plot was r2= 0.069 (mean difference -0.03 log sec). Using three categories: poor (840-300 seconds of arc), coarse (480-210 seconds of arc) and moderate-fine stereoacuity (210-30 seconds of arc). Positive predictive values were 89.5% for moderate-fine; 72.7% for coarse; and 90.0% for poor stereoacuity. In addition, the agreement was evaluated using the Kappa coefficient (K= 0.743) with a 0.95 confidence interval and lower and upper Kappa limits were (0.628 and 0.858), respectively. Kappa coefficient and limits were still good when analyzing data before (K =0.663, 0.420 and 0.906) and after the treatment (K= 0.765, 0.632 and 0.899). CONCLUSION: The Computerized Stereoscopic Game test allows the measure of stereoacuity. It can be used for both the purpose of detecting stereo vision deficits or tracking stereo vision development.

Predictive factors for the perceptual learning in stereodeficient subjects

Background: Stereopsis is a valuable feature of human visual perception which is critically impaired in amblyopia, but can be improved through perceptual learning (PL). This article aims to determine the variables affecting the outcomes and intensity of a stereoacuity stimulation program.MethodsRe-analysis of a previous study in stereodeficient subjects with a history of amblyopia. Sixteen subjects (12 females, 4 males) aged between 7 and 14 received stereopsis stimulation through a PL program at home. A correlation analysis evaluated whether treatment intensity or percentage improvement were related to age or baseline stereoacuity measurements. Further analysis was performed to assess whether the type of amblyopia conditioned the PL treatment (Fischer Statistical Test).ResultsNo significant correlation was found between age and percentage improvement (rho=−0.08, p=0.749), nor was age correlated with treatment intensity (rho=0.170, p=0.544). However, a correlation did exist between baseline stereoacuity levels and treatment intensity (rho=0.734, p=0.001). Baseline stereoacuity and percentage improvement had a negative correlation (rho=−0.748, p=0.005), while treatment intensity showed only a weak association with the type of amblyopia (p=0.064).ConclusionsPresent results suggest that perceptual learning in stereodeficient subjects is not influenced by either the subject's age or the type of amblyopia. Baseline stereoacuity, on the other hand, seems to be a predicting factor for perceptual learning outcomes. According to our study, subjects with poor basal stereoacuity needed more sessions to improve and their percentage improvement was lower. However, due to the reduced size of the sample, the results should be considered with caution. (AU)

Impact of Trifocal and Trifocal Toric Intraocular Lenses on Spectral-domain OCT Retinal Measurements.

PRECIS: Monofocal, trifocal, and trifocal toric intraocular lenses (IOLs) induce similar changes on overall retinal optical coherence tomography (OCT) measurements. PURPOSE: The purpose of this study was to assess whether trifocal and trifocal toric IOLs affect the measurement of retinal parameters using spectral-domain OCT. METHODS: This cross-over study included patients undergoing implantation of a trifocal IOL: AcrySof IQ PanOptix, a trifocal toric IOL: AcrySof IQ PanOptix Toric, and a monofocal IOL: AcrySof IQ. The monofocal group was considered as the control group. The refractive target was emmetropia in all cases. Mean average macular thickness, macular volume, and retinal nerve fiber layer (RNFL) thickness were measured with the Cirrus HD-OCT. All measurements were performed before and 3 months after the surgery. RESULTS: The study analyzed 150 eyes of 150 patients (50 for each IOL group). Macular thickness and macular volume showed statistically significant differences before and after the surgery for the 3 groups (P<0.05 in all cases). RNFL thickness was found to be similar before and after the surgery in all groups (P>0.05 in all cases). Mean difference values (before and after the surgery) in the monocular, trifocal, and trifocal toric group for macular thickness, macular volume, and RNFL thickness were 4.9±7.8, 7.9±10.0, and 7.7±13.7 µm, respectively; 0.1±0.2, 0.2±0.4, and 0.2±0.3 mm3, respectively; and 0.8±5.5, 1.3±6.0, and 0.8±6.7 µm, respectively. Mean differences were found to be similar for the 3 groups. CONCLUSION: The trifocal and the trifocal toric IOLs under study did not induce an additional impact on spectral-domain OCT retinal measurements compared with monofocal IOLs.

Complex interactions between meteorological parameters and the thermal regime of two tropical, high altitude crater lakes (Nevado de Toluca, Mexico).

Using long-term time series of meteorological and water-column parameters, the dynamics of two lakes separated by about 500 m from each other by a central lava dome, located at 4207 m above sea level in the volcano crater of Nevado de Toluca, Mexico were explored. Because of the strong wind-forcing previously measured on the volcano slope and the proximity of the lakes, wind-mixing was expected, with similar dynamics in both lakes. However, the meteorological parameters in the crater were significantly different than on the slope of the volcano, due to the dome and the high walls of the crater, which weakened wind speeds, modified wind direction, and reduced exposure to solar radiation by almost 20% in the crater compared to on the volcano slope. The rate and depth of thermal penetration into each lake differed by an order of magnitude, related with differential insolation due to crater wall shading, along with differences in transparency, most likely due to differential algal growth and suspended matter. At times, rapid surface cooling occurred during periods of reduced insolation and calm winds, leading to strong vertical convection and the formation of a characteristic step profile in the water column rather than the predicted wind mixing. These results are important for interdisciplinary studies of these and other alpine lakes and, in particular for biophysical coupling in these unique hydrological systems.

Automated refraction after trifocal and trifocal toric intraocular lens implantation.

BACKGROUND: To analyze the correlation between automated refraction and manifest refraction after implantation of a trifocal intraocular lens or its toric version. METHODS: This cross-sectional study involved 105 eyes of 105 patients. Subjects were divided in two groups: 62 with trifocal (AcrySof PanOptix) and 43 with trifocal toric (AcrySof PanOptix Toric) intraocular lenses. Automated refraction was employed as starting point for obtaining the manifest refraction. Automated refraction and manifest refraction measurements were analyzed and compared using the vector analysis 3 months after the surgery. RESULTS: In both groups, the higher differences between automated refraction and manifest refraction measurements were found for the cylinder and the spherical equivalent (M). Cylinder values for PanOptix were: -0.60 ± 0.36 D with automated refraction and -0.17 ± 38 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.49 ± 0.31 D with automated refraction and -0.05 ± 0.21 D with manifest refraction (p < 0.001). M values for PanOptix were: -0.23 ± 0.31 D with automated refraction and -0.03 ± 0.16 D with manifest refraction (p < 0.001); for PanOptix Toric, the values were: -0.13 ± 0.40 D with automated refraction and 0.01 ± 0.12 D with manifest refraction (p < 0.001). For the PanOptix group, intraclass correlation coefficients were: 0.51 (sphere), 0.64 (cylinder), 0.42 (M), 0.62 (J0), and 0.37 (J45). For the PanOptix Toric group, the intraclass correlation coefficients were: 0.39 (sphere), 0.61 (cylinder), 0.39 (M), 0.53 (J0), and 0.09 (J45). CONCLUSION: The results of this study suggest that patients implanted with the trifocal and the trifocal toric intraocular lens under study showed similar automated refraction results between them, with a slight trend to more negative amounts of cylinder and M. Nevertheless, clinicians should carefully confirm all parameters of the refraction with manifest refraction.

Optical tolerance to rotation of trifocal toric intraocular lenses as a function of the cylinder power.

BACKGROUND: The aim was to assess the impact of 5- and 10-degree rotations in the optical quality of a trifocal toric intraocular lens with different amounts of cylinder. METHODS: Two Physiol Toric intraocular lenses with 1.5 and 3.0 D of cylinder were analysed in three different positions: centred, 5 and 10 degrees rotated. The optical quality of the intraocular lenses was evaluated with the PMTF optical bench through specific perpendicular targets. The analysis was performed by the through-focus modulation transfer function curves and the modulation transfer function corresponding to distance vision (0 D of vergence). RESULTS: For a centred situation, the through-focus modulation transfer function curves of both intraocular lenses showed the classical three peaks corresponding to the powers of the two principal meridians of the intraocular lenses. When 5 and 10 degrees of rotation were induced, the three peaks were attenuated in both cases. The case with the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation showed the worst optical quality and a significant loss of trifocality. The modulation transfer function values obtained for distance vision also showed the worst optical quality for the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation. CONCLUSION: Rotations over 5 degrees decreased the optical quality of trifocal toric intraocular lenses, being this reduction moderate from 5 to 10 degrees for low levels of cylinder (≤1.5 D). For mid-high levels of cylinder (≥3.0 D), rotations over 5 degrees cause a significant loss of optical quality at all object distances.