Revisiting Javal's rule: a fresh and improved power vector approach according to age.

PURPOSE: The scientific community has established Javal's rule as a model linking refractive (RA) and keratometric (KA) astigmatism since its appearance more than 100 years ago. The aim was to improve the accuracy of this relationship according to subject's age by applying the power vector analysis. Posterior corneal curvature has also been studied. METHODS: The IOLMaster 700 optical biometer was used to measure the corneal thickness and the radius of curvature of the anterior and posterior corneal surfaces. Refractive error was determined by a non-cycloplegic subjective refraction process with trial lenses. Linear regression analyses were applied using J0 and J45 power vector components. An evaluation was carried out according to the subject's age resulting into eight regression relationships for each astigmatic vector component for each relationship. RESULTS: A total of 2254 right eyes from 2254 healthy subjects were evaluated. A trend towards against-the-rule astigmatism (ATR) was found with aging, both for refractive astigmatism (RA) and keratometric astigmatism (KA), with 95.2% of subjects under 20 years old having with-the-rule (WTR) KA, and only 22.8% above 79 years old. The following regression equations were found between RA and KA: [Formula: see text] = 0.73 × [Formula: see text] - 0.18 (R = 0.78) and [Formula: see text] = 0.70 × [Formula: see text] + 0.04 (R = 0.69) and between RA and total corneal astigmatism (TCA): [Formula: see text] = 0.73 × [Formula: see text] + 0.13 (R=0.78) and [Formula: see text] = 0.70 × [Formula: see text] - 0.06 (R = 0.68) for the whole sample, but with sensible differences among age groups, both in the slope and in the intercept. CONCLUSION: Ignoring the age of the subject when using Javal's rule could lead to an error in the final cylinder calculation that would increase in high astigmatisms. Applying this new power vector approach based on subject's age could improve the accuracy of the astigmatism prediction.

Soft Contact Lens Engraving Characterization by Wavefront Holoscopy.

Permanent engravings on contact lenses provide information about the manufacturing process and lens positioning when they are placed on the eye. The inspection of their morphological characteristics is important, since they can affect the user's comfort and deposit adhesion. Therefore, an inverted wavefront holoscope (a lensless microscope based on Gabor's principle of in-line digital holography) is explored for the characterization of the permanent marks of soft contact lenses. The device, based on an in-line transmission configuration, uses a partially coherent laser source to illuminate the soft contact lens placed in a cuvette filled with a saline solution for lens preservation. Holograms were recorded on a digital sensor and reconstructed by back propagation to the image plane based on the angular spectrum method. In addition, a phase-retrieval algorithm was used to enhance the quality of the recovered images. The instrument was experimentally validated through a calibration process in terms of spatial resolution and thickness estimation, showing values that perfectly agree with those that were theoretically expected. Finally, phase maps of different engravings for three commercial soft contact lenses were successfully reconstructed, validating the inverted wavefront holoscope as a potential instrument for the characterization of the permanent marks of soft contact lenses. To improve the final image quality of reconstructions, the geometry of lenses should be considered to avoid induced aberration effects.

How Do Different Digital Displays Affect the Ocular Surface?

SIGNIFICANCE: Digital display use has been accepted as a contributing factor to dry eye disease. Nowadays, plenty of new models of digital displays have been developed, and the differences in their nature and the ways in which they are set and used may contribute to differences in the eye-related problems they cause. PURPOSE: This study aimed to analyze the differences in ocular surface, tear film, and visual fatigue parameters after reading on different digital displays, with and without initial instillation of artificial tears. METHODS: Thirty-one healthy individuals ranging in age from 20 to 26 years (mean ± standard deviation, 21.26 ± 1.73 years) were included in this prospective clinical study. Subjects' ocular surface, tear film, and visual fatigue parameters were assessed after reading for 15 minutes on a laptop computer, tablet, e-reader, and smartphone with matching characteristics and a baseline measurement. Measurements were taken with and without the instillation of artificial tears before the reading tasks and included the Ocular Surface Disease Index questionnaire, the Computer Vision Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, bulbar redness, and pupil size. RESULTS: Statistically significant differences in the Ocular Surface Disease Index, Computer Vision the Syndrome Questionnaire, tear meniscus height, the Schirmer I test, noninvasive keratograph break-up time, osmolarity, and bulbar redness were obtained when comparing the displays (P < .05). Best results were obtained with the smartphone and the e-reader. Conversely, the computer produced the highest disturbance on the ocular surface and tear film. Finally, the instillation of artificial tears revealed no statistical improvement of ocular surface or tear film parameters for the same device (P > .05). CONCLUSIONS: Taking into account the clinical tests for dry eye diagnosis, the smartphone may be considered as the least disturbing display, producing lower dry eye signs and symptoms in comparison with other devices.

Ocular biometric changes with different accommodative stimuli using swept-source optical coherence tomography.

PURPOSE: To evaluate ocular biometric changes with different accommodative stimuli using a new swept-source optical biometer. METHODS: Only the right eye was analyzed. Each subject was measured six times with the IOLMaster 700 swept-source optical biometer (Carl Zeiss Meditec, Jena, Germany) with the subject looking at the stimulus shown by the instrument and with the subject looking at a target placed outside the instrument at 0D of vergence. Axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), lens thickness (LT), white-to-white (WTW), and keratometry readings (K1 and K2) were evaluated in both cases. To assess if the changes found may affect the intraocular (IOL) power calculation for surgical applications, we have applied some formulae, using the software provided by the optical biometer manufacturer, to the ocular parameters found in both situations for three different types of IOLs. RESULTS: No statistically significant differences were found for AL, CCT, WTW, K1 and K2 between the subject looking at the stimulus of the biometer and looking at the outside target at 0D of vergence (p > 0.05). However, the measurement of ACD revealed a statistically significant reduction of 20 microns (p = 0.03) and, on the contrary, LT increased significantly 30 microns (p = 0.02). ACD and LT changes were highly correlated (R2 = 0.91). As for the IOL power calculation, in all cases, the mean change was lower than 0.25 D both for IOL power selection and residual refraction. CONCLUSIONS: Although ACD and LT change significantly with different accommodative stimuli measured by swept-source optical biometry, these changes are not clinically relevant.

Repeatability assessment of anterior segment biometric measurements under accommodative and nonaccommodative conditions using an anterior segment OCT.

PURPOSE: As accommodation is a dynamic process changing anterior ocular structures, we aim to compare the repeatability between the biometric measurements taken with and without accommodation. METHODS: Thirty healthy right eyes were measured in a baseline and an accommodative state using Visante-OCT. Three repeated measurements were taken to obtain central corneal thickness (CCT), anterior chamber depth (ACD), angle-to-angle distance (ATA), iridocorneal angles (IA), and crystalline lens thickness (LT). Repeatability was evaluated by the calculation of coefficient of repeatability (CoR), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). In addition, the Passing-Bablok regression method was applied. RESULTS: For the nonaccommodative state, the CoR for CCT, ACD, ATA, and LT was 20.02 µm, 0.09 mm, 0.25 mm, and 0.12 mm respectively. The CoR for CCT, ACD, ATA, and LT in the 6D-accommodative state was 20.85 µm, 0.08 mm, 0.26 mm, and 0.14 mm respectively. IA had similar results for both states; the CoR ranged between 3 and 4°, CoV was less than 4%, and the ICC was between 0.984-0.988. There were no significant differences between the three repeated measurements for any measurement. CONCLUSIONS: Visante-OCT provides good repeatability for anterior segment measurements for both accommodative and nonaccommodative states.

Accommodative stimulus-response curves to low-pass filtered natural images.

PURPOSE: To assess how the monocular steady-state accommodative stimulus-response curve is modified when viewing low-pass filtered natural images. METHODS: Eighteen adult subjects participated in the study. The accommodative stimulus-response curve was objectively assessed by means of a Hartmann-Shack wavefront sensor. Measurements were taken at different accommodative demands. Target images were low-pass filtered versions of a natural image that were obtained applying different digital spatial filters that limited the spatial frequency content of the natural image. Cutoff spatial frequencies were set at 30, 21, and 15 cycles per degree (cy/deg). RESULTS: Mean data obtained for each target were fitted to linear models. For the low-pass filtered natural image with a cutoff spatial frequency at 30 cy/deg, the slope for the averaged stimulus-response curve was 0.614, while the slopes obtained for the other two low-pass filtered images corresponding to cutoff frequencies at 21 and 15 cy/deg were 0.613 and 0.619, respectively (p < 0.01). The determination coefficient was R2 ≥ 0.988 for all targets. An ANCOVA analysis revealed that these slopes were not significantly different from each other (p = 0.82). Additionally, accommodative error indexes were obtained to measure both the discrepancy between the regression lines and the ideal lines and the degree of correlation between the stimulus and the response. CONCLUSIONS: Our study reveals that the low and middle spatial frequencies (< 15 cy/deg) are the most important to guide to the needed levels the accommodative response to natural images.

In vitro optical quality of monofocal aspheric toric intraocular lenses: effect of cylindrical power.

PURPOSE: To assess the in vitro optical quality of monofocal aspheric toric intraocular lenses (IOLs) as a function of the cylindrical power. METHODS: The in vitro optical quality of the AcrySof IQ Toric IOLs SN6AT2, SN6AT3, SN6AT4, SN6AT5 and SN6AT6 (Alcon Laboratories Inc., Forth Worth, TX, USA) was assessed with an instrument conceived for measuring Zernike's coefficients at 3.0- and 5.0-mm apertures. As a reference, the aspheric monofocal lens AcrySof IQ Aspheric SN60WF (Alcon Laboratories Inc., Forth Worth, TX, USA) was also measured. The area of visibility and cut-off frequency were used to describe the modulation transfer function (MTF) of each lens; meanwhile, the light in the bucket and the diameter of a circular area centred on the point-spread function (PSF) peak that captures 50% of the light energy were used to describe the PSF of each lens. Finally, an image simulation was computed from the Zernike values with reference purposes. RESULTS: Small differences were found on the metrics used for describing the MTF and PSF of the lenses at both tested apertures, but these were not statistically significant (p > 0.05). Furthermore, the image simulation showed that these differences would not have clinical relevance at all. CONCLUSIONS: The optical performance of the AcrySof IQ toric IOLs in terms of MTF and PSF is good and seems to be independent of the cylindrical power and similar to a non-toric aspheric lens.

Semiautomatic procedure to assess changes in the eye accommodative system.

PURPOSE: The aim of this pilot study was to evaluate a new semiautomatic procedure to assess in vivo changes in the crystalline lens and ciliary muscle during accommodation. METHODS: A total of 14 subjects were divided into two groups, young (aged between 20 and 25 years) and adult (aged between 35 and 40 years), and measured with an anterior segment optical coherence tomography. A semiautomatic procedure was implemented to measure the central lens thickness (CLT), anterior lens radius (ALR) and the ciliary muscle area (CMA) for the unaccommodated eye and for a vergence of - 3.00 D. RESULTS: The CLT increase for each population group was smaller than 5%, and the dispersion of each group was similar between them. Contrariwise, the reduction in the ALR was about 30% for both groups, although the young one showed the largest variability. The CMA increase was smaller than 30% for both groups, and the dispersion was similar between them. For each metric, differences between both groups were not statistically significant. CONCLUSIONS: The semiautomatic procedure seems to be useful for the in vivo analysis of the accommodative system. Additionally, the results obtained showed that changes in the CLT were much smaller compared to those obtained for the ALR or CMA.

Non-invasive measurements of the dynamic changes in the ciliary muscle, crystalline lens morphology, and anterior chamber during accommodation with a high-resolution OCT.

PURPOSE: The purpose of the study was to assess non-invasively the changes in the anterior chamber eye, crystalline lens morphology, and ciliary muscle during accommodation by means of an anterior chamber optical coherence tomographer (OCT), and correlate them with vergence. METHODS: Twenty-five eyes of twenty-five healthy subjects, whose mean age was 29.9±7.1 years, were included and measured with an anterior chamber OCT. The central corneal thickness (CCT), anterior chamber depth (ACD), anterior crystalline lens radius of curvature (ALRC), crystalline lens thickness (CLT), and ciliary muscle area (CMA) were measured for each participant at 0, -1, -2, and -3 D of target vergence. A linear model was used to assess the correlation of each eye parameter with the vergence demand. RESULTS: The mean CCT showed no change for all the accommodative stimuli. The mean ACD and ALRC decreased with the vergence, about 4.5 and 30 % at -3 D, respectively. On the contrary, the CLT and CMA showed an opposite tendency, where the mean CLT was increased by 4.0 % and the mean CMA was done by 26% at -3 D. Statistical significant differences (p < 0.001) were obtained among all vergences for each eye metric, except for the CCT (p = 0.76). CONCLUSION: The ACD and ALRC decreased about 2 and 10 % per dioptre of accommodation, respectively; whereas the CLT and CMA increased about 2 and 9 %, respectively. These results add knowledge regarding the understanding of accommodation and give new perspectives for biomechanics and biometry.

Evaluation of the repeatability of a swept-source ocular biometer for measuring ocular biometric parameters.

PURPOSE: The purpose was to evaluate the repeatability of a new swept-source optical biometer for measuring ocular biometric parameters. METHODS: Thirty subjects with healthy and phakic eyes were included in this study, and only one eye per participant was analysed. Each eye was measured five times with the IOLMaster 700 swept-source optical biometer (Carl Zeiss Meditec, Jena, Germany). Axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), lens thickness (LT), white-to-white (WTW), and K1 and K2 keratometric readings were evaluated. The repeatability of swept-source biometry was evaluated on the basis of five measurements captured for each patient. RESULTS: The repeatability limits for the axial measurements AL, ACD, CCT, and LT were 0.03, 0.07, 0.004, and 0.11 mm, respectively. For the WTW distance and both keratometry readings, the repeatability limits were 0.20, 0.06, and 0.05 mm, respectively. The AL resulted in the lowest coefficient of variation, and the LT had the highest one. The spherical equivalent showed statistically significant negative correlations with the AL and ACD. CONCLUSION: Swept-source optical biometry showed high repeatability performance for all biometric parameters in healthy eyes, where the correlation between the spherical equivalent and AL showed the strongest value.

Ocular anatomic changes for different accommodative demands using swept-source optical coherence tomography: a pilot study.

PURPOSE: The purpose of our study was to assess the changes in ocular parameters for different accommodative demands using a new optical biometer based on swept-source optical coherence tomography (SS-OCT). METHODS: Seven subjects were included in this pilot study, and only one eye per participant was analyzed. Each eye was measured six times with the optical biometer IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany). As this instrument is not able to change the vergence of the stimulus, to enable measurements at different accommodative states, a tilted first-surface mirror attached to the optical biometer was used to place the fixation stimulus at different vergences. Measurements were taken on the right eye of the subject while the left eye was looking through the mirror. Central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white-to-white (WTW) distance and keratometric readings were evaluated for three different accommodative states: 0.0 diopters (D), 1.5 D, and 3.0 D. RESULTS: No statistically significant differences were found for CCT, AL, WTW, K1 and K2 between the three accommodative states. As expected, changing the accommodative condition did not change CCT, AL, WTW, and keratometric outcomes. Nevertheless, statistically significant differences between the accommodative states were found for ACD and LT measurements. In addition, variations in ACD correlated linearly with variations in LT (R2 ≥ 0.99) when changing the vergence of the optotype. CONCLUSION: A practical methodology to assess the changes in ocular parameters for different accommodative demands using the IOLMaster 700 based on SS-OCT has been described. Statistically significant changes that have been found that agree well with previous reports.

Human eyes do not need monochromatic aberrations for dynamic accommodation.

PURPOSE: To determine if human accommodation uses the eye's own monochromatic aberrations to track dynamic accommodative stimuli. METHODS: Wavefront aberrations were measured while subjects monocularly viewed a monochromatic Maltese cross moving sinusoidally around 2D of accommodative demand with 1D amplitude at 0.2 Hz. The amplitude and phase (delay) of the accommodation response were compared to the actual vergence of the stimulus to obtain gain and temporal phase, calculated from wavefront aberrations recorded over time during experimental trials. The tested conditions were as follows: Correction of all the subject's aberrations except defocus (C); Correction of all the subject's aberrations except defocus and habitual second-order astigmatism (AS); Correction of all the subject's aberrations except defocus and odd higher-order aberrations (HOAs); Correction of all the subject's aberrations except defocus and even HOAs (E); Natural aberrations of the subject's eye, i.e., the adaptive-optics system only corrected the optical system's aberrations (N); Correction of all the subject's aberrations except defocus and fourth-order spherical aberration (SA). The correction was performed at 20 Hz and each condition was repeated six times in randomised order. RESULTS: Average gain (±2 standard errors of the mean) varied little across conditions; between 0.55 ± 0.06 (SA), and 0.62 ± 0.06 (AS). Average phase (±2 standard errors of the mean) also varied little; between 0.41 ± 0.02 s (E), and 0.47 ± 0.02 s (O). After Bonferroni correction, no statistically significant differences in gain or phase were found in the presence of specific monochromatic aberrations or in their absence. CONCLUSIONS: These results show that the eye's monochromatic aberrations are not necessary for accommodation to track dynamic accommodative stimuli.

Effect of Decentration on the Optical Quality of Two Intraocular Lenses.

PURPOSE: To analyze the effect of decentration on the optical quality of two diffractive-refractive intraocular lenses, a bifocal and a trifocal, when displaced laterally (horizontal direction) from the center. METHODS: The AT LISA 809M IOL (+3.75 D add) with two main foci and the AT LISA tri 839MP intraocular lens with three main foci (Carl Zeiss Meditec AG, Jena, Germany) were analyzed. The optical quality of the intraocular lenses was measured with the PMTF (power and modulation transfer function [MTF] measurement for refractive and diffractive intraocular lenses) optical bench (Lambda-X, Nivelles, Belgium). The optical quality of the lenses was evaluated by the MTF at different object vergences, the average modulation in the range of frequencies from 0 to 100 cycles/mm, and the through-focus MTF curves. All measures were recorded when the intraocular lenses were centered and decentered for 3.0- and 4.5-mm apertures. The Strehl ratio and the percentage of energy allocated at each focus at the centered position were also obtained. RESULTS: Our results showed a lower optical quality with increasing decentration. The MTFs for the diffractive-refractive intraocular lenses decreased when the intraocular lenses were decentered. Also, the relative percentages of light energy allocated at each object vergence, for both intraocular lenses, agreed well with theoretical specifications and were consistent with the overall design of each lens. CONCLUSIONS: The optical quality of these diffractive-refractive multifocal intraocular lenses was slightly reduced when the induced decentration was less than 0.4 mm. For a decentration of 0.4 mm, the maximum difference in average modulation values was about 18% compared to the centered position.

Opto-mechanical artificial eye with accommodative ability.

The purpose of this study was to describe the design and characterization of a new opto-mechanical artificial eye (OMAE) with accommodative ability. The OMAE design is based on a second-pass configuration where a small source of light is used at the artificial retina plane. A lens whose focal length can be changed electronically was used to add the accommodation capability. The changes in the OMAE's aberrations with the lens focal length, which effectively changes the accommodative state of the OMAE, were measured with a commercial aberrometer. Changes in power and aberrations with room temperature were also measured. The OMAE's higher-order aberrations (HOAs) were similar to the ones of the human eye, including the rate at which fourth-order spherical aberration decreased with accommodation. The OMAE design proposed here is simple, and it can be implemented in an optical system to mimic the optics of the human eye.

Vecto-keratometry: determination of anterior corneal astigmatism in manual keratometers using power vectors.

BACKGROUND: A new keratometric routine that employs power vector management for manual keratometers is described. This study evaluates the agreement of the new proposed keratometric technique with the classical one. RESEARCH DESIGN AND METHODS: The applicability of a new keratometric routine was verified using Helmholtz's and Javal's keratometers. Results were obtained by two different and well-trained examiners over two different samples, one including 65 and the other 74 eyes, respectively. Both conventional keratometry and the newly proposed routine (named vecto-keratometry) were used in each eye to obtain the results. The clinical agreement between the methods was evaluated using Bland-Altman and Passing-Bablok analysis. RESULTS: For Helmholtz's keratometer, Bland-Altman plots showed good agreement between methods for both astigmatic components being J0 = 0.04 ± 0.20 D and J45 = -0.07 ± 0.17 D. For Javal's keratometer, Passing-Bablok regression test determined regression line for J0 difference as y0 = 1.03, confidence interval: [0.98, 1.10] and regression line for J45 difference as y45 = 0.97, confidence interval: [0.83, 1.12]. CONCLUSIONS: Vecto-keratometry provides accurate clinical results. It has been demonstrated that there are no significant differences between methods in any of the power vector astigmatic components; thus, both methods can be applied interchangeably.

Light distortion of soft multifocal contact lenses with different pupil size and shape.

PURPOSE: To study the light distortion effects of soft multifocal contact lenses and the influence of different pupil size and shape. METHODS: A total of 14 eyes of 7 healthy contact lens users (mean age 28.6 ± 8.5 years) were recruited. The "Light Disturbance Analyser" device was employed for light characterization. The selected lenses were the monthly disposable "Biofinity multifocal" (CooperVision, CA, USA), both centre-distance and centre-near designs (addition power +2.50 D). Two circular pupils of 3 mm and 5 mm of diameter, and an elliptical shape (3 horizontal and 5 vertical mm) were used. Metrics such as the light distortion index (LDI), best-fit circle radius and its irregularity were analysed, among others. RESULTS: The LDI was generally higher with multifocal lenses, varying from 3.7 ± 0.3 % of the single vision lens to 6.1 ± 3.3 % of the multifocal centre-distance design and the 5-mm pupil. Larger pupils gave higher LDI values, changing from 4.5 ± 2.0 % (3 mm) to 6.1 ± 3.3 % (5 mm) with the centre-distance design. The elliptical pupil produced the largest discrepancy in the distortion size between the vertical and horizontal directions. The centre-distance and centre-near designs behaved similarly in terms of light distortion. CONCLUSIONS: The multifocal contact lenses of the study increased light distortion effects under low light conditions, especially with larger pupils. The shape of the distortion pattern is associated with the shape of the pupil. It seems that not all, but a big percentage of light distortion would be produced by the presence of the out-of-focus images given by a multifocal lens.

Influence of contrast polarity on the accommodative response.

PURPOSE: To assess the changes in the accommodative response of the eye while reading a text under different contrast polarity conditions: black letters on white background (BoW condition) and white letters on black background (WoB condition). METHODS: Eighteen subjects with ages ranging from 21 to 41 years participated in this experimental study. The accommodative response (AR) of the eye while reading a text with BoW or WoB contrast polarity was obtained objectively with an adaptive optics system that corrected all aberrations but subject's own. Two different letter sizes (visual acuity conditions), shown on a microdisplay, were tested. The AR of each eye was measured with its natural pupil diameter at 0-3D of accommodative demand from the far point of the eye, with a step of 0.5D. The slope of the stimulus-response curve was calculated for each subject and condition. RESULTS: The averaged maximum pupil size was bigger for reverse (WoB) than for normal (BoW) contrast with statistical significance. The slopes for the ARs of the four conditions were not significantly different from each other. CONCLUSIONS: Contrast polarity does not seem to influence the accommodative response when reading text from an electronic microdisplay.

Multisectorial changes in the ciliary muscle during accommodation measured with high-resolution optical coherence tomography.

PURPOSE: To measure changes in the anterior ciliary muscle during accommodation at the nasal, superior, temporal, and inferior sectors by means of an anterior chamber optical coherence tomographer, and correlate them with vergence changes. METHODS: Twenty-four subjects with healthy, phakic eyes, whose mean age was 27.1 ± 8.9 years, underwent measurement with an anterior chamber optical coherence tomographer. The anterior ciliary muscle was measured at the nasal, temporal, superior, and inferior sectors for 0, -1, -2, and -3 D of vergence. A linear model was used to assess the correlation of each eye parameter with the accommodative demand. RESULTS: The anterior ciliary muscle area significantly increased with accommodation for each sector, with a maximum increase of about 30% for the nasal-temporal sectors and about 25% for the inferior-temporal sectors. The linear model showed a tendency toward a positive relationship between change in the ciliary muscle area of each sector and vergence. CONCLUSION: The anterior ciliary muscle area tends to increase with accommodation, although the increase has been shown to be symmetric between the pair sectors superior-nasal and inferior-temporal. These results may help to increase understanding of accommodation biometry and biomechanics.

Repeatability assessment of biometric measurements with different refractive states and age using a swept-source biometer.

BACKGROUND: We aim to assess if refractive error or age may influence the repeatability of measurements using a swept-source biometer. METHODS: A total of 61 subjects were evaluated with IOLMaster 700 acquiring measurements of axial length (AL), central corneal thickness (CCT), white-to-white distance (WTW), anterior aqueous depth (AQD), lens thickness (LT), and keratometry (K) readings. Repeatability was evaluated classifying the sample according to the refractive state and age by the calculation of the within-subject standard deviation (Sw), coefficient of repeatability, and intraclass correlation coefficient. RESULTS: Very similar Sw was acquired among groups for AL, CCT, and WTW. Differences found for AQD, LT, keratometry and astigmatism among refractive and age groups were not clinically significant. Refractive groups obtained a Sw for AQD between 0.016 and 0.026, while for LT was between 0.023 and 0.029 mm. Besides, Sw showed values from 0.014 to 0.029 mm for keratometry. Age groups obtained a Sw of 0.025 and 0.016 mm for AQD, and 0.029 and 0.018 mm for LT, respectively. Sw was 0.019 vs 0.018 mm for K1, 0.014 vs 0.031 mm for K2. CONCLUSIONS: IOLMaster 700 showed good repeatability for biometric and keratometric parameters in eyes classified according to their refractive error or age.

Effect of age in the ciliary muscle during accommodation: Sectorial analysis.

PURPOSE: To compare changes in the ciliary muscle area at different sectors between pre-presbyopic and presbyopic eyes during accommodation by means of an anterior segment optical coherence tomographer (OCT). METHODS: The anterior ciliary muscle area was measured in 20 healthy and phakic pre-presbyopic eyes, whose mean age was 23.3±4.4 years, and in 20 healthy and phakic presbyopic eyes, whose mean age was 46.5±5.2 years. The relative change in the cross-sectional area of the ciliary muscle was measured at the nasal, inferior, and temporal sectors between 0 and -3 D of vergence, in -1 D step. A linear model was used to assess the correlation of each eye parameter with the accommodative demand. RESULTS: Each population group showed a significant increase in the anterior ciliary muscle area for each sector. The maximum increase in the ciliary muscle area within the pre-presbyopic group was about 30%, and for the presbyopic one was about 25%. At the same time, it was obtained that the larger the vergence, the larger the variability. Furthermore, the linear model showed a positive tendency between the change in the ciliary muscle area of each sector and the vergence for both population groups, which coefficient of determination was in all cases greater than 0.93. CONCLUSION: The anterior ciliary muscle area tends to increase with accommodation. The presbyopic nasal, inferior, and temporal ciliary muscle seem to have the same contractile capability as the young presbyopic ciliary muscle. These results might help to increase the evidences in the knowledge regarding the modern understanding of accommodation biometry and biomechanics.