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PurposeTo compare myopia progression in children randomized to MiSight contact lenses (CLs) versus children corrected with single-vision spectacles (SV) over a 2-year period.MethodsSubjects aged 8 to 12 with myopia (−0.75 to −4.00 D sphere) and astigmatism (< −1.00 D cylinder) were assigned to the lens study group (MiSight) or the control group (single vision). Measurements of visual acuity and subjective refraction were taken at 6-month intervals, and axial length, anterior chamber, corneal power, and cycloplegic autorefraction were measured at the baseline, 12-month, and 24-month visits.ResultsEighty-nine subjects were recruited. Forty-fix children were assigned to the MiSight group, and 33 to the single-vision spectacle group. In total, 74 children completed the clinical trial, with the following parameters at the beginning of the study: n =  41 in the MiSight group (age: 11.01 ± 1.23 years, spherical equivalent: −2.16 ± 0.94 D, gender: male: 21, female: 20) and n = 33 in the single-vision group (age: 10.12 ± 1.38 years, spherical equivalent: −1.75 ± 0.94 D, gender: male: 12, female: 21). After 2 years of follow-up, myopia progressed slowly in the MiSight group compared to the control group (0.45 D vs 0.74 D, p < 0.001) and there was less axial elongation in the MiSight group compared to the single-vision group (0.28 mm vs 0.44 mm, p < 0.001). Therefore, use of MiSight CLs produced lower myopia progression (39.32%) and lower axial growth of the eye (36.04%) at 2 years compared to spectacle use.ConclusionsMiSight contact lens wear reduces axial elongation and myopia progression in comparison to distance single-vision spectacles in children.ClinicalTrials.gov Identifier: NCT01917110.

This pilot study examined the immediate effects of a single session of vergence training using automatic dual-rotational Risley prisms (ADRRPs) on binocular visual function and reaction time in youth badminton athletes. Twenty-six participants were randomly assigned to a visual training (VT) group ( n  = 16) or a control group ( n  = 10). After a 15-minute ADRRPs session, the VT group showed greater short-term improvements in vergence facility (VF) and accommodative facility (AF) than the control group, and a reduction in reaction time was also observed. Other parameters, including amplitude of accommodation (AA), near point of convergence (NPC), and positive fusional vergence (PFV), showed minimal or non-significant changes, suggesting limited short-term oculomotor adaptation. These findings indicate that brief, automated vergence interventions may be feasible for enhancing specific visual functions and visuomotor responsiveness in athletes. However, given the small and uneven sample together with the short-term design, these preliminary results should be interpreted cautiously, and larger, longer-term studies are warranted.

PurposeTo compare clinical outcomes of bilateral implantation of hybrid multifocal intraocular lenses (IOLs) versus mix-and-match implantation of hybrid multifocal and extended-depth-of-focus (EDOF) versus mix-and-match implantation of hybrid multifocal and enhanced monofocal IOLs.MethodsPatients with bilateral age-related cataract were randomised in one of three groups: group 1, bilateral hybrid multifocal IOL; group 2, EDOF in the dominant eye, hybrid multifocal in the non-dominant eye; group 3, enhanced monofocal in the dominant eye, hybrid multifocal in the non-dominant eye. Assessments at 6 months postoperatively included monocular and binocular uncorrected distance visual acuity (UDVA), intermediate (UIVA) and near distance (UNVA) at 40 and 33 cm, defocus curves, contrast sensitivity (CS), reading speed and questionnaires on quality of vision and dysphotopsia.Results75 patients (25 per group) were enrolled. There were no statistically significant differences in binocular UDVA and UNVA between groups (p>0.05); binocular UIVA was better for group 1 and 2 versus group 3 (p=0.030). Binocular uncorrected defocus curve showed better performance for group 1 compared with group 3 from −2.00 to −3.50 D. Significantly higher reading speed was measured for Jaeger 1 font in group 1. There were no differences in CS between groups, but higher incidence of starbursts in group 1 and higher need for near spectacles in group 3.ConclusionBilateral hybrid multifocal IOL implantation resulted in better near vision, but higher rates of photic phenomena compared with the mix-and-match groups. Combinations of IOLs may allow surgeons to fine-tune for individual patient’s needs.

Purpose To evaluate the tolerance to refractive errors of a new purely refractive extended depth of focus (EDF) intraocular lens (IOL), TECNIS PureSee™ IOL, using preclinical and clinical metrics. Methods Preclinical evaluation included computer simulations of visual acuity (sVA) and dysphotopsia profile of different IOL designs (refractive EDF, diffractive EDF, multifocal, standard, and enhanced monofocals) using an appropriate eye model with and without ±0.50 D defocus and/or +0.75 D of astigmatism. Patients bilaterally implanted with a refractive EDF (Model ZEN00V, TECNIS PureSee™ IOL) or an enhanced monofocal (Model ICB00, TECNIS Eyhance™ IOL) IOL from a prospective, randomized study were included. At the 6-month postoperative visit, uncorrected and corrected distance vision (UDVA and CDVA), visual symptoms, satisfaction and dependency on glasses were evaluated in a subgroup of patients with absolute residual refractive error of >0.25 D in one or both eyes. Results In the presence of defocus and astigmatism, sVA was comparable for all except the multifocal IOL design. The refractive EDF was more tolerant to myopic outcomes and maintained a monofocal-like dysphotopsia profile with defocus. Binocular logMAR UDVA was −0.03 ± 0.08 for ZEN00V and −0.02 ± 0.11 for ICB00. 100% ZEN00V and 97% ICB00 patients did not need glasses and were satisfied with their distance vision. Monocular CDVA, contrast sensitivity and visual symptoms were also similar between both groups. Conclusions The clinical outcomes of the refractive EDF IOL demonstrated high quality distance vision and dysphotopsia comparable to a monofocal IOL, even in the presence of refractive error, thus matching the design expectations of the EDF IOL.

BackgroundTraditional treatment of amblyopia involves either wearing a patch or atropine penalisation of the better eye. A new treatment is being developed on the basis of virtual reality technology allowing either DVD footage or computer games which present a common background to both eyes and the foreground, containing the imagery of interest, only to the amblyopic eye.MethodsA randomised control trial was performed on patients with amblyopia aged 4–8 years with three arms. All three arms had dichoptic stimulation using shutter glass technology. One arm had DVD footage shown to the amblyopic eye and common background to both, the second used a modified shooter game, Nux, with sprite and targets presented to the amblyopic eye (and background to both) while the third arm had both background and foreground presented to both eyes (non-interactive binocular treatment (non-I-BiT) games).ResultsSeventy-five patients were randomised; 67 were residual amblyopes and 70 had an associated strabismus. The visual acuity improved in all three arms by approximately 0.07 logMAR in the amblyopic eye at 6 weeks. There was no difference between I-BiT DVD and non-I-BiT games compared with I-BiT games (stated primary outcome) in terms of gain in vision.ConclusionsThere was a modest vision improvement in all three arms. Treatment was well tolerated and safe. There was no difference between the three treatments in terms of primary stated outcomes but treatment duration was short and the high proportion of previously treated amblyopia and strabismic amblyopia disadvantaged dichoptic stimulation treatment.Trial registration numberNCT01702727, results.

Purpose To assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching. Methods Quasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group. Results Significant improvements in VA were found in both groups at 1 month ( p  < 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively ( p  = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month ( p  < 0.001). Likewise, the binocular function score also increased significantly in VT group ( p  = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis ( p  < 0.001, R 2  = 0.747). Conclusions A combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children.

Purpose To compare clinical outcomes for patients implanted with either FineVision HP or FineVision Triumf intraocular lenses (IOL) (Beaver-Visitec International, Inc) following cataract surgery. Methods Twenty-six patients bilaterally implanted with the HP IOL and 27 patients with the Triumf IOL were followed up for 6 months in a prospective randomized study. Refraction, uncorrected and corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuity (DCIVA), and uncorrected and distance-corrected near visual acuity (DCNVA) were evaluated. Defocus curves and contrast sensitivity were also measured. Patient-reported outcomes were assessed using the National Eye Institute Visual Function Questionnaire 25, and adverse events were registered. Results Ninety-four percent of the eyes in both groups were within ±1.00 diopter (D) of spherical equivalent. All of the patients had 20/20 or better binocular CDVA in both groups and 96% and 100% had 20/25 or better binocular CDIVA in the Triumf and HP IOL groups, respectively, being reduced to 32% and 91.7% for DCNVA, respectively. Differences between groups were statistically significant from −2.00 to −4.50 D with better visual acuity outcomes for the HP IOL group (P < .01). Better monocular photopic contrast sensitivity was found for the Triumf IOL group at 12 and 18 cycles per degree (P < .01). There was a statistically significant increase of the overall composite score in both groups before and after surgery (P < .001). Spectacle independence was similar between groups for distance and intermediate vision but higher for the HP IOL for near vision (96% versus 75%). There were no adverse events related to the IOLs. Conclusions Both IOLs showed good and comparable distance and intermediate visual acuities but near vision was better for the HP IOL. This model provided higher spectacle independence for near vision. [J Refract Surg. 2025;41(3):e102–e113.]

To evaluate visual outcomes at different distances (near, intermediate, and far), depth of focus, optical quality, quantitative dysphotopsia, and patient satisfaction in two groups. The extended depth of focus (EDOF) only group (n = 40 eyes) was implanted bilaterally with an EDOF intraocular lens (IOL) and the mixed group (n = 40 eyes) was implanted with the same EDOF IOL in the dominant eye and a trifocal IOL in the fellow eye. At the 3-month postoperative visit, refractive outcomes and monocular and binocular uncorrected (UDVA) and corrected (CDVA) distance visual acuities for far UDVA, CDVA, distance-corrected intermediate visual acuity (DCIVA) at 80 cm, uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA) at 40 cm, and binocular defocus curve were evaluated. The mean spherical equivalent (SE) 3 months postoperatively was -0.16 ± 0.41 diopters (D) in the EDOF only group and -0.39 ± 0.63 D in the mixed group. In the EDOF only group, binocular visual acuities were: UDVA = -0.04 ± 0.07 logMAR (20/18); CDVA = -0.04 ± 0.06 logMAR (20/18); DCIVA (80 cm) = 0.07 ± 0.19 logMAR (20/23); DCNVA (40 cm) = 0.32 ± 0.15 logMAR (20/42); and UNVA (40 cm) = 0.24 ± 0.17 logMAR (20/35). In the mixed group, binocular visual acuities were: UDVA = 0.03 ± 0.09 logMAR (20/21) (P = .08); CDVA = -0.01 ± 0.07 logMAR (20/20) (P = .25); DCIVA (80 cm) = 0.24 ± 0.23 logMAR (20/35) (P = .08); DCNVA (40 cm) = 0.19 ± 0.07 logMAR (20/31) (P = .03); and UNVA (40 cm) = 0.18 ± 0.10 logMAR (20/30) (P = .37). Effective restoration of visual acuity was demonstrated in both groups, with high levels of visual quality and patient satisfaction. Better results in near visual acuity were demonstrated in the mixed group. [J Refract Surg. 2019;35(7):408-416.].

To investigate the visual outcomes between mix-and-match bifocal intraocular lenses (IOLs) (ReSTOR +2.50 and +3.00 diopters [D]; Alcon Laboratories, Inc., Fort Worth, TX) versus bilateral implantation of a trifocal IOL (FineVision; PhysIOL, Liège, Belgium). Twenty-three patients (average age: 56.3 ± 6.9 years; range: 45 to 71 years) referred for lens phacoemulsification and IOL implantation were included in this study. Patients were randomly assigned to two groups. The FineVision group was bilaterally implanted with the FineVision trifocal IOL and the ReSTOR group was implanted with mix-and-match bifocal ReSTOR +2.50 and +3.00 D IOLs. A 3-month postoperative check was performed, and manifest refraction and logMAR uncorrected (UDVA) and corrected (CDVA) distance and near visual acuities were recorded. Monocular and binocular defocus curve testing was performed under photopic (85 cd/m ) conditions in 0.50-D defocus steps. Contrast sensitivity was measured monocularly and binocularly under mesopic conditions at spatial frequencies of 3, 6, 12, and 18 cycles per degree using the CSV-1000 contrast test (VectorVision, Greenville, OH). There were no reported differences in monocular distance visual acuity or refractive outcomes between groups (P > .05). Furthermore, there were no significant differences in contrast sensitivity between the three IOLs (P > .05). The FineVision group achieved better monocular and binocular near and intermediate visual acuities under defocus curve testing than the ReSTOR group (P < .05). Binocular implantation of the FineVision trifocal IOL provided a better range of visual acuities at near and intermediate distances than mix-and-match bifocal IOL implantation. [J Refract Surg. 2016;32(10):659-663.].

Parts of material previously presented at Annual Meetings of the Association for Research in Vision and Ophthalmology and the American Association of Pediatric Ophthalmology and Strabismus. Trial Registration: ClinicalTrials.gov Identifier: NCT00212134.