Explore the vast range of titles available.

To compare two different diffractive trifocal intraocular lens (IOL) designs, evaluating longer-term refractive outcomes, visual acuity (VA) at various distances, low contrast VA and quality of vision. Patients with binocularly implanted trifocal IOLs of two different designs (FineVision [FV] and Panoptix [PX]) were evaluated 6 months to 2 years after surgery. Best distance-corrected and uncorrected VA were tested at distance (4 m), intermediate (80 and 60 cm) and near (40 cm). A binocular defocus curve was collected with the subject's best distance correction in place. The preferred reading distance was determined along with the VA at that distance. Low contrast VA at distance was also measured. Quality of vision was measured with the National Eye Institute Visual Function Questionnaire near subset and the Quality of Vision questionnaire. Thirty subjects in each group were successfully recruited. The binocular defocus curves differed only at vergences of -1.0 D (FV better, =0.02), -1.5 and -2.00 D (PX better, <0.01 for both). Best distance-corrected and uncorrected binocular vision were significantly better for the PX lens at 60 cm ( <0.01) with no significant differences at other distances. The preferred reading distance was between 42 and 43 cm for both lenses, with the VA at the preferred reading distance slightly better with the PX lens ( =0.04). There were no statistically significant differences by lens for low contrast VA ( =0.1) or for quality of vision measures ( >0.3). Both trifocal lenses provided excellent distance, intermediate and near vision, but several measures indicated that the PX lens provided better intermediate vision at 60 cm. This may be important to users of tablets and other handheld devices. Quality of vision appeared similar between the two lens designs.

To compare ocular surface outcomes between interventional glaucoma treatment with trabecular micro-bypass stent implantation and continued topical intraocular pressure-lowering therapy. A prospective, single-center, contralateral-eye study of patients with bilateral, mild-to-moderate open-angle glaucoma undergoing implantation of the iStent inject in the study eye, while the fellow eye (control eye) continued topical medications. Just over half the eyes in both groups underwent phacoemulsification. Ocular surface parameters were evaluated using objective tests and validated symptom questionnaires at baseline and at 1, 3, and 6 months. Fifty-six eyes were included, 28 in each group. At 6 months, medication use reduced significantly in study eyes (from 1.9±1.0 preoperatively to 0.4±0.6; p<0.001), but not in control eyes (from 1.5±0.9 to 1.4±0.8; p=0.168). Study eyes demonstrated significant improvements in keratograph bulbar redness score (2.4±0.6 to 2.0±0.4; p=0.003), and Oxford ocular surface staining (OSS) score (1.6±1.2 to 0.7±1.0; p<0.001) while control eyes did not; improvements in bulbar redness and OSS scores were significantly greater in study eyes (p=0.005 and p=0.045, respectively). Patient-reported symptoms improved significantly: OSDI (Ocular Surface Disease Index) scores decreased from 18.4 ± 16.4 to 9.3 ± 8.9 (p=0.007) and SPEED (Standard Patient Evaluation of Eye Dryness) II scores decreased from 8.0 ± 7.8 to 4.5 ± 4.1 (p=0.005). Interventional glaucoma treatment with trabecular micro-bypass stent implantation significantly reduced medication burden, which was associated with improved signs and symptoms of ocular surface disease at 6 months. Compared to fellow eyes on topical therapy, stent-treated eyes showed better outcomes in selected ocular surface parameters, supporting the benefits of an interventional approach.

To quantify the changes in the binocular defocus curve associated with the Vivity™ non-diffractive extended vision intraocular lens when the dominant eye was targeted for emmetropia and the non-dominant eye was artificially targeted for slight myopia using spectacles. This was a non-interventional research study of the corrected binocular defocus curve associated with binocular emmetropia (Setting A) and with emmetropia in the dominant eye and two different levels of myopia simulated in the non-dominant eye (-0.50 D, Setting B and -1.00 D, Setting C). Subjects were patients implanted with the AcrySof IQ Vivity intraocular lens in both eyes 3 to 12 months previously. Using the defocus data, the percentage of subjects with a continuous 2.5 D range of vision (distance to 40 cm) was calculated for various levels of minimum visual acuity (VA). Forty subjects were enrolled. The mean spherical equivalent refraction was -0.06 D ± 0.36 D, with 0.37 D ± 0.29 D of refractive cylinder. There was no statistically significant difference in the mean VA at -0.25 D or at -0.50 D vergences between the test Settings, but there was a statistically significant difference at all other vergences. Differences were particularly noticeable at -2.00 D, -2.50 D and -3.00 D, where higher myopia in the non-dominant eye yielded better binocular VA. A 2.5 D range of functional vision (20/25) was achieved by 38% of subjects at Setting A, 68% of subjects at Setting B and 85% of subjects at Setting C. At setting C, all but one subject (39/40, 97.5%) had a 2.5 D range of vision with a VA of 20/32 or better. Significant gains in binocular near vision, with only a nominal effect on distance vision, can be achieved with the Vivity IOL by leaving the non-dominant eye of patients with 0.50 D or 1.00 D of myopia.

The aim of this study was to compare visual acuity at various distances (far, intermediate and near), low contrast acuity and contrast sensitivity after trifocal toric and extended depth of focus (EDOF) toric intraocular lens (IOL) implantation. This was a non-interventional two-arm comparative study of visual outcomes after uncomplicated bilateral cataract or refractive lens exchange surgery with IOL implantation between 6 months and 5 years before a single diagnostic examination visit. There was no masking and no control group. Subjects had to have uncorrected distance visual acuity (UDVA) of 20/40 (0.3 logMAR) or better measured at the time of their study visit. Clinical evaluations included the manifest refraction, visual acuity (VA) at distance, intermediate (60 cm) and near (40 cm), low contrast (10%) VA and contrast sensitivity. A total of 50 bilaterally implanted patients (25 trifocal, 25 EDOF) were examined; the two groups had similar characteristics, including corneal astigmatism. Postoperative refractive outcomes were also similar. There were no statistically significant differences in distance or intermediate VA between groups, but the trifocal group had significantly better near VA both uncorrected (p = 0.009) and distance-corrected (p = 0.014). There were no statistically significant differences in the low contrast acuity measures between IOLs at either distance or 40 cm, with or without glare. Contrast sensitivity in mesopic and photopic conditions was similar. The trifocal and EDOF toric IOLs performed similarly for all measures except near VA, where the trifocal toric provided significantly better acuity. For subjects interested in reducing spectacle independence at near, this may be an important consideration.

The primary objective was to investigate if subjects with dry eyes had increased variability of keratometry measurements prior to cataract surgery compared to subjects with non-dry eyes. Secondary objectives were to determine which separate signs affected keratometry. This study was part of a prospective interventional randomized controlled trial. After dry eye diagnostics were performed (signs only) subjects were divided into sign of dry eye (SDE) positive and negative groups. To investigate variability, we performed two keratometry measurements for each subject with three different optical biometers: Anterion (OCT optical biometer), Eyestar (combined OCT and reflection-based optical biometer), and Lenstar (reflection based-optical biometer). One hundred and thirty-one subjects were available for analysis. The variability of astigmatism was significantly higher for subjects with hyperosmolarity compared to normal eyes for the Lenstar, as was the percentage of eyes with variability of astigmatism greater than 0.25 D. The percentage of eyes with variability of average K greater than 0.25 D was higher for subjects with non-invasive keratograph break-up time <10 seconds (NIKBUT positive) compared to normal eyes for the Lenstar. Combined diagnostic criteria (signs only) showed no statistically significant differences for keratometry measurements between SDE positive and negative. Eyes with hyperosmolarity and NIKBUT positive showed statistically higher variability of keratometry measurements compared to normal eyes for Lenstar, but not for the Anterion or Eyestar biometers.

Eutrophication increases the acidity of coastal waters. Model simulations suggest that the drop in pH in coastal waters of the northern Gulf of Mexico since pre-industrial times is greater than that expected from eutrophication and ocean acidification alone. Human inputs of nutrients to coastal waters can lead to the excessive production of algae, a process known as eutrophication. Microbial consumption of this organic matter lowers oxygen levels in the water 1 , 2 , 3 . In addition, the carbon dioxide produced during microbial respiration increases acidity. The dissolution of atmospheric carbon dioxide in ocean waters also raises acidity, a process known as ocean acidification. Here, we assess the combined impact of eutrophication and ocean acidification on acidity in the coastal ocean, using data collected in the northern Gulf of Mexico and the East China Sea—two regions heavily influenced by nutrient–laden rivers. We show that eutrophication in these waters is associated with the development of hypoxia and the acidification of subsurface waters, as expected. Model simulations, using data collected from the northern Gulf of Mexico, however, suggest that the drop in pH since pre-industrial times is greater than that expected from eutrophication and ocean acidification alone. We attribute the additional drop in pH—of 0.05 units—to a reduction in the ability of these carbon dioxide-rich waters to buffer changes in pH. We suggest that eutrophication could increase the susceptibility of coastal waters to ocean acidification.

To provide normative visual acuity and quality of vision data related to bilateral implantation of a wavefront shaping presbyopia correcting intraocular lens (IOL). This was a non-interventional research study of the refraction, visual acuity (VA) and quality of vision achieved after bilateral implantation of a wavefront shaping presbyopia correcting intraocular lens between 3 months and 12 months post-surgery. The manifest refraction, and uncorrected and distance corrected VA at near, intermediate and distance (40 cm, 50 cm, 66cm, 4 m) were tested. Binocular mesopic VA at 4m and uncorrected photopic low contrast (25%) VA at 4 m were also tested, the latter with and without a glare source. A patient reported outcome questionnaire was administered. Defocus curve testing with and without simulated myopia in the non-dominant eye was also tested (reported elsewhere). Forty subjects completed the study. There was no statistically significant difference between the uncorrected and distance corrected VA at any distance. Mean logMAR binocular VAs were (-0.07 ± 0.07) at 4 m, (0.00 ± 0.07) at 66 cm and (0.07 ± 0.11) at 40 cm. Uncorrected photopic low contrast VA was statistically significantly better without glare (0.09 ± 0.10) compared to with glare (0.44 ± 0.21, p < 0.01). Reported glare, halos and starbursts were \"not at all\" Or \"a little\" bothersome for more than 95% of subjects. Hazy vision and blurred vision were reported most often. The Vivity IOL provided patients with good distance and intermediate vision, and functional near vision with low reported bother from glare, halos, or starbursts.

The primary objective was to investigate if treatment with artificial tears affected the variability of keratometry measurements for subjects with dry eyes prior to cataract surgery. The secondary objectives were to investigate whether treatment with artificial tears improved refractive precision and whether subjects with non-dry eyes had better refractive precision than subjects with dry eyes. Prospective randomized controlled trial with three arms. Dry eye diagnostics according to DEWS II were performed, and subjects with dry eyes were randomized to no treatment (group A1) or treatment with artificial tears two weeks prior to cataract surgery (group A2), with the third group (Group B, non-dry eyes) as a control. Keratometry was performed twice at baseline and twice after two weeks at the time of cataract surgery with three different optical biometers. The change in mean variability of keratometry (average K and magnitude of vector differences) and percentages of outliers after two weeks versus baseline were compared for group A2. The refractive and astigmatism prediction errors were calculated eight weeks after cataract surgery and compared for all three groups. One hundred thirty-one subjects were available for analysis. There was no statistically significant difference in the mean variability of keratometry or percentages of outliers for group A2 from baseline to the time of cataract surgery. There was no statistically significant difference in refractive precision (absolute error and astigmatism prediction error) between any groups. Subjects with dry eyes (treated and non-treated) achieved the same refractive precision and percentages of outliers as subjects with non-dry eyes. Treatment with artificial tears for two weeks appeared inadequate to significantly affect variability in biometric measurements for patients with dry eyes prior to cataract surgery. DEWS II criteria for DED may not be optimal in a cataract setting.

To compare the visual acuity (VA) and quality of vision between bilateral implantation of a trifocal intraocular lens (IOL) and blended bifocal IOLs with an intermediate add in the dominant eye and a near add in the nondominant eye. Patients with either trifocal or blended bifocal IOLs implanted were recruited after surgery. Subjects returned for a single diagnostic visit between 3 and 24 months after surgery. VA was tested at various distances, including low-contrast acuity and acuity at their preferred reading distance. A binocular defocus curve was obtained, and subjective visual function and quality of vision were evaluated. Twenty-five trifocal subjects and 30 blended bifocal subjects were enrolled. There were no significant differences in low-contrast acuity, preferred reading distance, or acuity at that reading distance. Binocular vision at 4 m, 60 cm, and 40 cm was not statistically significantly different. The trifocal provided statistically significantly better visual acuity (P<0.05) at vergences from -0.5 to -1.5 D (from 2 m to 67 cm viewing distance, P<0.05). There was no statistically significant difference in the near vision subscale scores of the 39-question National Eye Institute Visual Function Questionnaire or the overall scores of the Quality of Vision questionnaire, though significantly more trifocal subjects reported that the observed visual disturbances were \"bothersome\" (P<0.05). Both lens modalities provided subjects with excellent binocular near and distance vision, with similar low rates of visual disturbances and good reported functional vision. The trifocal IOL provided significantly better intermediate VA in the viewing distance range of 2 m to 67 cm, corresponding to viewing things such as a car dashboard or grocery shelf. VA was similar between groups at viewing distances from 60 to 40 cm, corresponding to computer or reading distance.

To evaluate the agreement of refractive predictability of a swept-source optical coherence tomography (SS-OCT) biometer, which uses segmental AL calculation, with another SS-OCT biometer, and an optical low coherence reflectometry (OLCR) biometer. The secondary objective was to describe the refractive outcomes, visual acuities, and the agreement of different preoperative biometric parameters. The study was a retrospective one-arm study of refractive and visual outcomes after successful cataract surgery. Preoperative biometric data were collected with two different SS-OCT device (Argos, Alcon Laboratories and Anterion, Heidelberg Engineering) and an OLCR device (Lenstar 900, Haag-Streit). The Barrett Universal II formula was used to calculate IOL power for all three devices. Follow-up examination was 1-2 months after surgery. The main outcome measure, refractive prediction error (RPE), was calculated as the achieved postoperative refraction minus the predicted refraction for each device. Absolute error (AE) was calculated by reducing the mean error to zero. The study included 129 eyes of 129 patients. The mean RPE was 0.06, -0.14 and 0.17 D for the Argos, Anterion and Lenstar, respectively ( < 0.01). The Argos also had the lowest absolute RPE, while the Lenstar had the lowest median AE, but this was not statistically significant ( > 0.2). The percentages of eyes with RPE within ±0.5 was 76%, 71%, and 78% for the Argos, Anterion, and Lenstar, respectively. The percentages of eyes with AE within 0.5 D was 79%, 84%, and 82% for the Argos, Anterion and Lenstar, respectively. None of these percentages were statistically significantly different ( > 0.2). All three biometers showed good refractive predictability with no statistically significant differences in AE or percentages of eyes within ± 0.5 D of RPE or AE. The lowest arithmetic RPE was found with the Argos biometer.