Jorge Manuel Martins Jorge
@uminho.pt
Universidade do Minho
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Jorge Jorge and João Pedro Jorge
Informa UK Limited
CLINICAL RELEVANCE
In many sports, dynamic visual acuity is used. In order to improve dynamic visual acuity, it is important to understand the aspects of the visual system that can cause compromise.
BACKGROUND
To investigate the parameters of the visual system that may influence dynamic visual acuity in professional soccer players.
METHODS
In 2022, 40 professional players were analysed. Screening consisted of a survey, the measurement refractive error, and static and dynamic visual acuity and the binocular vision parameters. All athletes were men with a mean age of 24.9 ± 4.8 years.
RESULTS
The mean refractive error was -0.29 ± 0.61D, and 22.5% of athletes are myopic only and 7.5% hyperopic. Static visual acuity was R: -0.037 ± 0.094 LogMAR , L: -0.036 ± 0.098 LogMAR. Dynamic visual acuity was 0.154 ± 0.118 LogMAR . There is a positive and moderate correlation between monocular static visual acuity and dynamic visual acuity, with r = 0.524 (r2 = 0.275 , p < 0.001) for the right eye and r = 0.553 (r2 = 0.306, p < 0.001) for the left eye. For the component of astigmatism (J = 0) and for stereopsis in distance vision, the correlation was, r = -0.472 (r2 = 0.223, p = 0.002) and r = -0.467 (r2 = 0.218, p = 0.002), respectively.
CONCLUSION
Athletes with lower static visual acuity in distance vision, or with worse stereopsis in distance vision or more myopic astigmatism, have lower dynamic visual acuity than other athletes.
Jorge Jorge, José Teixeira, Tiago Pinhão, Frederico Delgado, Alshaarawi Salem, Francesco Martino, and Sotiris Plainis
Frontiers Media SA
BackgroundVision is crucial for football players, impacting decision-making and athletic performance. Despite its global popularity, football lacks comprehensive evaluations of the impact of digital device use on ocular symptoms during high-demand activities.PurposeTo gain knowledge about the time spent by football players in high visual demand activities, the symptoms associated with binocular vision dysfunction, and their relationship with sports performance.MethodsA cross-sectional observational study was conducted in 2020 using an online survey targeting football players from Portugal, England, Spain, and Saudi Arabia. The survey, distributed over 5 weeks, aimed to collect data from approximately 5,000 football players. Information on player profiles, competitive levels, vision habits, and symptoms related to binocular vision dysfunctions was collected. The Convergence Insufficiency Symptom Survey (CISS) employed a 5-point Likert scale to indicate the average frequency of each symptom. Due to non-normality, non-parametric tests were used (p &lt; 0.05). Specifically, Mann-Whitney U, Kruskal-Wallis, Chi-square, and Spearman's rank correlation tests were used as appropriate.ResultsAnalyzing male professional football players (mean age: 27.4 ± 5.0 years, 95% CI, 26.7–28.1), it was found that 38.1% of the players had been called up to the national team and 6.9% had played over 50 games. Self-rated last season's performance had a mean score of 6.5 ± 2.1 (95% CI, 6.2–6.8)(on a scale of 1 to 10). Smartphone use exceeded 1 h daily for all players, with 36.0% surpassing 4 h. Visual symptoms, notably associated with smartphone use (35.5%), were observed. Regarding the CISS score, the mean was 7.1 ± 7.7 (IC95%: 6.6 to 8.8). A weak negative correlation (rho = −0.215, p = 0.003) emerged between CISS scores and self-perceived sports performance. Football players using prescription lenses had significantly higher CISS scores (11.9 ± 10.4, 95% CI, 12.3–7.7) compared to non-users (6.2 ± 6.8, 95% CI, 7.8–5.7) (p &lt; 0.001).ConclusionThis study reveals that professional football players engage in high visual demand tasks, notably on smartphones. One-third of the players link smartphone use to ocular symptoms. The Convergence Insufficiency Symptoms Survey indicates that 6.3% exhibit binocular vision dysfunction symptoms. Those with fewer ocular symptoms perceive that they have better sports performance than their counterparts.
Jorge Jorge, Alberto Diaz-Rey, and Madalena Lira
Informa UK Limited
CLINICAL RELEVANCE
The extent of binocular vision dysfunction in elite soccer players needs to be determined as it may impact performance.
BACKGROUND
The purpose of the study was to investigate the prevalence of binocular vision dysfunctions in elite soccer players.
METHODS
One hundred and seven professional soccer players were evaluated. Refractive error was measured and the following binocular vision parameters were assessed: horizontal and vertical phoria for distance and near vision, the values of break and recovery for negative and positive fusional vergences at distance and near vision, vergence facility at distance and near vision, monocular accommodative facility at near vision, and near point of convergence (break and recovery points). All the athletes were men with a mean age of 24.4 ± 4.8 years.
RESULTS
No athlete was diagnosed with divergence excess, divergence insufficiency, or basic exophoria. About 13.0% of the athletes have binocular vision dysfunctions related to esophoria (0.9% with esophoria at near vision and 12.1% with esophoria at distance and near vision). About 10.3% have convergence insufficiency and 2.8% were diagnosed with fusional vergence dysfunction. The only accommodation-related parameter analysed was accommodative infacility, and 6.5% of the athletes had this dysfunction. Vertical phoria was present in 3.7% of the athletes. No statistically significant differences were found based on in athletes with respect to ethnicity, position occupied on the field, age, ametropia or laterality.
CONCLUSION
The overall prevalence of binocular vision dysfunction in elite soccer players was 36.4%. The most prevalent dysfunctions are related to the presence of esophoria (13.0%). The values found point out the need to include binocular vision assessment protocols in the visual assessment routine for athletes.
Vera Lúcia Alves Carneiro and Jorge Jorge
Elsevier BV
Purpose The World Health Organization places the Optometrist as the primary eye care provider, clearly defining its competencies and scope of practice. In Portugal, there are no studies about Optometrists professional competencies and the profession remains unregulated. The aim of this study was to describe the Portuguese optometrists’ professional competencies model and to identify possible training needs felt. Methods A questionnaire survey was carried out, with the Portuguese optometric population as target group, ascertaining the level of academic qualifications, the clinical procedures most frequently performed, the training needs felt and the confidence levels in the performance of certain procedures. Results The 444 validated surveys represent 28.41% of the study population, making it a representative sample. The validated sample had 78.8% of Graduates, 20.5% of Masters and 0.7% of PhDs in Optometry. Conclusions The results of this study allowed us to conclude that the competences most frequently performed by Portuguese optometrists are a very reductive view of the internationally stipulated, based on Refraction, Basic Ocular Health Assessment, Contactology and Paediatric Optometry in School Age (>6 years old). The most important training needs occur at the level of Applied Ocular Pharmacology, Prismatic Prescription, Optometry in Special Needs Populations, Contactology in Special Cases, Low Vision and Clinical/Hospital Internship. Professional experience of 10 years or more and Master’s/PhD qualifications give rise to more skills, higher levels of confidence and lower training needs. Higher frequency of execution of certain procedures translates into high levels of confidence and less training needs in the area.
Ana Amorim-de-Sousa, Linda Moreira, Rute Macedo-de-Araújo, André Amorim, Jorge Jorge, Paulo R. Fernandes, António Queirós, and José M. González-Méijome
Springer Science and Business Media LLC
Purpose To investigate the effect of different hydrophilic and rigid gas-permeable contact lens (CL) materials on multifocal electroretinography (mfERG). Methods The mfERG was recorded in 18 healthy subjects with RETI-port/scan21™: 11 subjects underwent mfERG recording wearing two different hydrophilic CLs with different water contents in a randomized order (1 silicone hydrogel—Comfilcon A, 48%EWC, and 1 hydrogel—Omafilcon A, 62% EWC) and 7 other subjects wore a hydrophobic rigid gas-permeable scleral lens (SL)—Hexafocon A. Control measures were recorded without CL in both groups. mfERG recordings were performed with a stimulus array pattern of 103-scaled hexagons displayed on a 19-inch RGB monitor at 28 cm distance at a frame rate of 60 Hz. The amplitude (nV), implicit time and response density (nV/deg 2 ) of the first-order kernel components N1, P1 and N2 were evaluated for the total mfERG response and for the response averages of 4 quadrants and of 6 successive concentric rings. Subjects were optically corrected for the working distance of ERG display. Results Hydrophobic material significantly decreased the P1 amplitude of the total mfERG response, at Rings 3, 4 and 6 and Quadrant 4 (> 53.77 ± 43.2 nV; P ≤ 0.050), as well as the total (− 71.59 ± 50.68 nV) and Ring 6 (− 104.76 ± 79.88 nV) N2 amplitude ( P ≤ 0.043). N1, P1 and N2 peak times suffered significant changes with both hydrophilic CL ( P ≤ 0.050). Omafilcon A significantly increased P1 amplitude of Ring 5 and N2 amplitude of Ring 4, when compared to baseline (52.40 ± 71.87 nV; P = 0.036) and to Comfilcon A (39.51 ± 48.63 nV; P = 0.023), respectively. Conclusions Hydrophobic CL slightly attenuated the strength of the mfERG signal, especially at the middle to peripheral retinal areas, while hydrophilic CL slightly changed the implicit time of the response. Different hydrophilic CL materials might affect the mfERG response differently. When considering the measurement of mfERG obtained with a CL in place, researchers should bear in mind that some changes can be related to CL material.
Jorge Jorge and Paulo Fernandes
Informa UK Limited
The aim of this study was to investigate static and dynamic visual acuity, refractive error, and the use of visual compensation of elite football players.
Jorge Jorge, Ana Braga, and António Queirós
Ovid Technologies (Wolters Kluwer Health)
Purpose The aim of this study is to compare the changes in myopia prevalence among Portuguese first-year university students in 2002 and 2014 at the University of Minho. Methods The refractive status and axial length of first-year students at the School of Sciences, University of Minho, were measured in 2014. Refractive error was measured with subjective refraction under cycloplegia and axial length was measured by optical biometry. The data were compared with those obtained from a similar cohort of 111 students in 2002. Myopia was defined as a mean spherical equivalent of ⩽−0.50D. A survey was conducted to know the routine of the participants. They were asked how many hours per week (hrs/wk) they had spent, on average in the previous year, watching TV, using the computer, studying, participating in manual hobbies, and participating in outdoor activities. Results In 2014, 75 students were assessed (15 male and 60 female) with a mean age (mean ± SD) of 19.8 ± 1.6 years (ranging from 18 to 24 years). The mean refractive error M (spherical equivalent) was −0.77 ± 1.79D and the axial length was 23.74 ± 1.19 mm. The prevalence of myopia was 41.3% (31 of 75). In 2002, the mean refractive error M was 0.01 ± 1.53D, the axial length was 23.40 ± 0.93 mm, and the myopia prevalence was 23.4% (26 of 111). The differences between myopia prevalence and mean refractive error are statistically significant (p < 0.05). A statistically significant increase in the number of hrs/wk spent on near activities (p < 0.05) was found. Conclusions In 12 years, the prevalence of myopia among first-year university students at the School of Sciences of the University of Minho rose from 23.4 to 41.3%. This increase in myopia prevalence could be related to the lifestyle changes of the studied population.
José M. González-Méijome, Sofia C. Peixoto-de-Matos, Miguel Faria-Ribeiro, Daniela P. Lopes-Ferreira, Jorge Jorge, Jerry Legerton, and Antonio Queiros
Ovid Technologies (Wolters Kluwer Health)
Purpose: Higher myopic refractive errors are associated with serious ocular complications that can put visual function at risk. There is respective interest in slowing and if possible stopping myopia progression before it reaches a level associated with increased risk of secondary pathology. The purpose of this report was to review our understanding of the rationale(s) and success of contact lenses (CLs) used to reduce myopia progression. Methods: A review commenced by searching the PubMed database. The inclusion criteria stipulated publications of clinical trials evaluating the efficacy of CLs in regulating myopia progression based on the primary endpoint of changes in axial length measurements and published in peer-reviewed journals. Other publications from conference proceedings or patents were exceptionally considered when no peer-review articles were available. Results: The mechanisms that presently support myopia regulation with CLs are based on the change of relative peripheral defocus and changing the foveal image quality signal to potentially interfere with the accommodative system. Ten clinical trials addressing myopia regulation with CLs were reviewed, including corneal refractive therapy (orthokeratology), peripheral gradient lenses, and bifocal (dual-focus) and multifocal lenses. Conclusions: CLs were reported to be well accepted, consistent, and safe methods to address myopia regulation in children. Corneal refractive therapy (orthokeratology) is so far the method with the largest demonstrated efficacy in myopia regulation across different ethnic groups. However, factors such as patient convenience, the degree of initial myopia, and non-CL treatments may also be considered. The combination of different strategies (i.e., central defocus, peripheral defocus, spectral filters, pharmaceutical delivery, and active lens-borne illumination) in a single device will present further testable hypotheses exploring how different mechanisms can reinforce or compete with each other to improve or reduce myopia regulation with CLs.
Miguel Faria-Ribeiro, Daniela Lopes-Ferreira, Norberto López-Gil, Jorge Jorge, and José Manuel González-Méijome
Elsevier BV
PURPOSE
To evaluate the error in the estimation of axial length (AL) with the IOLMaster partial coherence interferometry (PCI) biometer and obtain a correction factor that varies as a function of AL and crystalline lens thickness (LT).
METHODS
Optical simulations were produced for theoretical eyes using Zemax-EE software. Thirty-three combinations including eleven different AL (from 20mm to 30mm in 1mm steps) and three different LT (3.6mm, 4.2mm and 4.8mm) were used. Errors were obtained comparing the AL measured for a constant equivalent refractive index of 1.3549 and for the actual combinations of indices and intra-ocular dimensions of LT and AL in each model eye.
RESULTS
In the range from 20mm to 30mm AL and 3.6-4.8mm LT, the instrument measurements yielded an error between -0.043mm and +0.089mm. Regression analyses for the three LT condition were combined in order to derive a correction factor as a function of the instrument measured AL for each combination of AL and LT in the theoretical eye.
CONCLUSIONS
The assumption of a single "average" refractive index in the estimation of AL by the IOLMaster PCI biometer only induces very small errors in a wide range of combinations of ocular dimensions. Even so, the accurate estimation of those errors may help to improve accuracy of intra-ocular lens calculations through exact ray tracing, particularly in longer eyes and eyes with thicker or thinner crystalline lenses.
Miguel Faria-Ribeiro, Norberto López-Gil, Rafael Navarro, Daniela Lopes-Ferreira, Jorge Jorge, and Jose Manuel González-Méijome
Ovid Technologies (Wolters Kluwer Health)
Purpose To describe a new methodology that derives horizontal posterior retinal contours from partial coherence interferometry (PCI) and ray tracing using the corneal topography. Methods Corneal topography and PCI for seven horizontal visual field eccentricities correspondent to the central 60 degrees of the posterior pole were obtained in 55 myopic eyes. A semicustomized eye model based on the subject’s corneal topography and the Navarro eye model was generated using Zemax-EE software. The model was used to compute the optical path length in the seven directions where PCI measurements were obtained. Vitreous chamber depth was computed using the PCI values obtained at each of those directions. Matlab software was developed to fit the best conic curve to the set of points previously obtained. We tested the limit in the accuracy of the methodology when the actual cornea of the subject is not used and for two different lens geometries. Results A standard eye model can induce an error in the retina sagitta estimation of the order of hundreds of micrometers in comparison with the semicustomized eye model. However, the use of a different lens model leads to an error of the order of tens of micrometers. The apical radius and conic constant of the average fit were −11.91 mm and −0.15, respectively. In general, a nasal-temporal asymmetry in the retina contour was found, showing mean larger values of vitreous chamber depth in the nasal side of the eye. Conclusions The use of a semicustomized eye model, together with optical path length measured by PCI for different angles, can be used to predict the retinal contour within tenths of micrometers. This methodology can be useful in studies trying to understand the effect of peripheral retinal location on myopia progression as well as modeling the optics of the human eye for a wide field.
Daniela Lopes-Ferreira, Cláudia Ribeiro, Helena Neves, Miguel Faria-Ribeiro, António Queirós, César Villa-Collar, Jorge Jorge, and José Manuel González-Méijome
Elsevier BV
José Manuel González-Méijome, Ana Carla da Silva, Helena Neves, Daniela Lopes-Ferreira, António Queirós, and Jorge Jorge
Elsevier BV
PURPOSE
To compare the performance of two novel multipurpose disinfecting solutions (MPDS) in preventing silicone hydrogel contact lens dehydration, provide higher scores of subjective comfort and stable optical quality during a month of lens wear in neophyte volunteers.
METHOD
This is a prospective, double-blind, contralateral and randomised study involving the contra lateral use of Complete RevitaLens and Biotrue MPDS. Twenty-five neophytes wore Air Optix Aqua for 1 month. Volunteers were evaluated on day 1 and day 30 at 2 and 10h after lens insertion. Tear film stability using Tearscope Plus (Keeler, UK), whole eye aberrations for 4.5mm pupil size (IRx3, ImaginEyes, France) and subjective comfort (0-10 score) along with the dehydration values obtained with a gravimetric method were collected at each follow-up visit.
RESULTS
NIBUT values decreased significantly with both care systems from baseline to 10h visit on day 1 (p=0.032 and 0.016, mean difference=-6.7s and -7.0 s, for Complete Revitalens and Biotrue, respectively). Dehydration rates and ocular aberrations did not change significantly over the month of follow-up (p>0.05, ANOVA with Bonferroni post hoc corrections), nor between visits within the same day (p>0.05, paired sample T-test). End-of-day dryness sensation worsened similarly with both MPDS after 1 month (p=0.021 and 0.005, mean difference=-1.4 and -1.3, for Complete Revitalens and Biotrue, respectively).
CONCLUSIONS
Regardless of their different chemical compositions in terms of moisture additives both MPDS solutions evaluated performed similarly regarding objective measures of dehydration, tear stability and optical quality but presented significant differences in subjective symptoms.
Paulo R.B. Fernandes, Helena I. F. Neves, Daniela P. Lopes-Ferreira, Jorge M.M. Jorge, and José M. González-Meijome
Ovid Technologies (Wolters Kluwer Health)
Purpose To compare visual performance with the Biofinity multifocal (MF) contact lens with monovision (MV) with the Biofinity single-vision contact lens. Methods A crossover study of 20 presbyopic patients was conducted. Patients were randomized first into either an MF or an MV lens for 15 days for each modality, with a washout period between each lens type. Measurements included monocular and binocular high- and low-contrast logarithm of the minimum angle of resolution visual acuity (VA) at distance and near visions, binocular distance contrast sensitivity function, and near stereoacuity. Results At 15 days, patients lost fewer than two letters (half a line of VA) of binocular distance and near VA, with the MF and MV lens under high- and low-contrast conditions (P > 0.05 for both comparisons). No statistically significant differences were seen in binocular VA at near or distance with either lens. However, the monocular distance VA improved significantly in the nondominant eye, with the MF lens by one line over the 15-day period under high-contrast (P = 0.023) and low-contrast (P = 0.035) conditions; this effect was not seen with the MV lens. Contrast sensitivity function was within the normal limits with both lenses. The stereoacuity was significantly (P < 0.01) better with MF than with MV. Conclusions Multifocal contact lens correction provided satisfactory levels of VA comparable with MV without compromising stereoacuity in this crossover study. The near vision significantly improved in the dominant eye, and the distance vision improved in the nondominant eye from 1 to 15 days with the MF lens, suggesting that patients adapted to the multifocality overtime, whereas this was not true for MV.
José Manuel González-Méijome, Jorge, Diaz-Rey, and Rosado
Informa UK Limited
Background The purpose of this study was to compare the accuracy of the new Sirius® Scheimpflug anterior segment examination device for measurement of central corneal thickness (CCT) and anterior chamber depth (ACD) with that of CCT measurements obtained by ultrasound pachymetry and ACD measurements obtained by ultrasound biometry, respectively. Methods CCT and ACD was measured in 50 right eyes from 50 healthy subjects using a Sirius Scheimpflug camera, SP100 ultrasound pachymetry, and US800 ultrasound biometry. Results CCT measured with the Sirius was 546 ± 39 μm and 541 ± 35 μm with SP100 ultrasound pachymetry (P = 0.003). The difference was statistically significant (mean difference 4.68 ± 10.5 μm; limits of agreement −15.8 to 25.20 μm). ACD measured with the Sirius was 2.96 ± 0.3 mm compared with 3.36 ± 0.29 mm using US800 ultrasound biometry (P < 0.001). The difference was statistically significant (mean difference −0.40 ± 0.16 mm; limits of agreement −0.72 to 0.07 mm). When the ACD values obtained using ultrasound biometry were corrected according to the values for CCT measured by ultrasound, the agreement increased significantly between both technologies for ACD measurements (mean difference 0.15 ± 0.16 mm; limits of agreement −0.16 to 0.45 mm). Conclusion CCT and ACD measured by Sirius and ultrasound methods showing good agreement between repeated measurements obtained in the same subjects (repeatability) with either instrument. However, CCT and ACD values, even after correcting ultrasound ACD by subtracting the CCT value obtained with either technology should not be used interchangeably.
Miguel Faria-Ribeiro, António Queirós, Daniela Lopes-Ferreira, Jorge Jorge, and José Manuel González-Méijome
Ovid Technologies (Wolters Kluwer Health)
Purpose To compare the patterns of relative peripheral astigmatic refraction (tangential and sagittal power errors) and eccentric eye length between progressing and stable young-adult myopes. Methods Sixty-two right eyes of 62 white patients participated in the study, of which 30 were nonprogressing myopes (NP group) for the last 2 years and 32 were progressing myopes (P group). Groups were matched for mean spherical refraction, axial length, and age. Peripheral refraction and eye length were measured along the horizontal meridian up to 35 and 30 degrees of eccentricity, respectively. Results There were statistically significant differences between groups (p < 0.001) in the nasal retina for the astigmatic components of peripheral refraction. The P group presented a hyperopic relative sagittal focus at 35 degrees in the nasal retina of +1.00 ± 0.83 diopters, as per comparison with a myopic relative sagittal focus of −0.10 ± 0.98 diopters observed in the NP group (p < 0.001). Retinal contour in the P group had a steeper shape in the nasal region than that in the NP group (t test, p = 0.001). An inverse correlation was found (r = −0.775; p < 0.001) between retinal contour and peripheral refraction. Thus, steeper retinas presented a more hyperopic trend in the periphery. Conclusions Stable and progressing myopes of matched age, axial length, and central refraction showed significantly different characteristics in their peripheral retinal shape and astigmatic components of tangential and sagittal power errors. The present findings may help explain the mechanisms that regulate ocular growth in humans.
António Queirós, César Villa-Collar, Jorge Jorge, Ángel Ramón Gutiérrez, and José Manuel González-Méijome
Elsevier BV
Background: To analyse the asphericity of the anterior corneal surface (ACS) for different diameters, and correlate those values with corneal higher order aberrations (cHOA) before and after myopic treatments with corneal refractive therapy (CRT) for orthokeratology and customized (CL) and standard laser (SL) assisted in situ keratomileusis (LASIK). Setting: Clinica Oftalmologica NovoVision, Madrid, Spain. Methods: The right eyes of 81 patients (27 in each treatment group), with a mean age of 29.94 ± 7.5 years, were analysed. Corneal videokeratographic data were used to obtain corneal asphericity (Q) for different corneal diameters from 3 to 8 mm and cHOA root mean square (RMS) obtained from Zernike polynomials for a pupil diameter of 6 mm. Results: There were statistically significant differences in asphericity values calculated at different corneal diameters for different refractive treatments and their changes. The difference between asphericity at 3 and 8 mm reference diameters showed statistically significant correlations with spherical-like cHOA that was also significantly increased after all procedures. Conclusions: The shift in corneal asphericity and the differences among different treatment techniques are more evident for the smaller reference diameters. These differences can be much reduced or even masked for a peripheral reference point at 4 mm from centre, which is used by some corneal topographers. © 2011 Spanish General Council of Optometry. Published by Elsevier Espana, S.L. All rights reserved.
Sílvia Oliveira, Jorge Jorge, and José M González-Méijome
Wiley
Citation information: Oliveira S, Jorge J & González‐Méijome JM. Dynamic accommodative response to different visual stimuli (2D vs 3D) while watching television and while playing Nintendo 3DS Console. Ophthalmic Physiol Opt 2012, 32, 383–389 doi: 10.1111/j.1475‐1313.2012.00934.x
António Queirós, César Villa-Collar, Jorge Jorge, Ángel Ramón Gutiérrez, and José Manuel González-Méijome
Ovid Technologies (Wolters Kluwer Health)
Purpose. To characterize the axial and off-axis refraction across the horizontal meridian of the visual field before and after myopic laser-assisted in situ keratomileusis (LASIK) surgery. This research took place at the Clinical Ophthalmologic-NovoVisión, Madrid, Spain. Methods. Twenty-six ODs (mean age ± SD = 30.4 ± 4.8 years) of 26 patients who underwent LASIK surgery to treat myopia between −0.75/−3.88 D of spherical equivalent (M) were included in the study. Peripheral refraction was evaluated by an open field auto-refractor before and after LASIK surgery at 3 months. Along with a complete set of examination procedures to assess suitability for treatment, the central and peripheral refractions were measured along the horizontal meridian up to 35° of eccentricity in the nasal and temporal retinal areas in 5° visual field steps. Results. Changes in M ranged between 1.85 ± 0.93 D at center to 0.33 ± 0.73 D at 35° in the nasal retina (p < 0.029 for all eccentricities). Treatment induced was symmetric between nasal and temporal visual fields along the horizontal meridian. The degree of myopic increase in relative peripheral refractive error as represented by the spherical equivalent for 30° (r2 = 0.462, p < 0.001) and 35° (r2 = 0.717, p < 0.001) eccentric refraction was correlated with axial spherical equivalent at baseline. Conclusions. Peripheral refraction is affected by myopic LASIK surgery. Unlike orthokeratology, which increases the peripheral myopia, LASIK reduces myopia across the horizontal visual field out to at least 35° from fixation.
Jose M. González-Méijome, Alejandro Cerviño, Sofia C. Peixoto-de-Matos, David Madrid-Costa, Jorge Jorge, and Teresa Ferrer-Blasco
Ovid Technologies (Wolters Kluwer Health)
Purpose: To show the use of high-resolution spectral-domain optical coherence tomography (HR-SOCT) for the in situ evaluation of epithelial, stromal, and contact lens (CL) thickness changes under closed-eye conditions without lens removal. Methods: Eight young healthy patients wore a thick soft CL for 90 minutes under closed-eye conditions, and measures of epithelial and stromal corneal thickness were obtained at regular intervals using a HR-SOCT (Copernicus HR; Optopol Tech. SA, Zawiercie, Poland). Results: Minimal changes in epithelial thickness were detected with a transient statistically significant increase in epithelial thickness in the fellow control eye 30 minutes after insertion (P = 0.028). A significant and progressive increase in stromal thickness up to 8% after 90 minutes of lens wear was observed at a constant rate of 2.5% every 30 minutes, being statistically significant in all observations (P < 0.001). Fellow control eyes also showed a significant increase in stromal thickness at a much lower rate of 0.5% every 30 minutes. Lens thickness decreased significantly by 2% after 90 minutes of lens wear under closed-eye conditions (P < 0.001). Individual analysis showed that all eyes displayed stromal swelling, whereas only half of them showed epithelial swelling. Conclusions: Increase in stromal thickness and a slight decrease in lens thickness were observed in response to a hypoxic stimulus under closed-eye conditions. HR-SOCT is a powerful tool to investigate in vivo the physiological interactions between cornea and CLs.
António Queirós, César Villa-Collar, Angel R. Gutiérrez, Jorge Jorge, and José M. González-Méijome
Ovid Technologies (Wolters Kluwer Health)
Purpose To evaluate different aspects of the visual-related quality of life using the National Eye Institute Refractive Error Quality of Life (NEI RQL)-42 questionnaire in low and moderate myopic subjects corrected with different refractive treatments including laser-assisted in situ keratomileusis (LASIK), orthokeratology (OK), soft contact lenses (SCLs), and spectacles. Methods The NEI RQL-42 questionnaire was administered to 217 subjects at one single clinic. All the questions consisted of 13 different subscales that were analyzed separately. The results from subjects with −1.00 to −3.00 diopter myopia corrected with LASIK (n=41), OK (n=37), SCLs (n=44), or spectacles (n=45) were compared with each other and with emmetropic subjects (n=50). Results Statistically significant differences among all groups were found in all subscales, except for satisfaction with correction (P=0.135). The average decrease in quality of life compared with emmetropes were −7.1% (P=0.021) for LASIK, −13.0% (P<0.001) for OK, −15.8% (P<0.001) for spectacles, and −17.3% (P<0.001) for SCLs. Conclusions Although all patients in each group were considered to be successfully visually corrected, quality of life related to vision was markedly different in certain NEI RQL-42 categories. LASIK showed the lowest average decrease in quality of vision compared with emmetropes. OK was comparable with LASIK in independence of visual correction, and SCL wear was superior to LASIK and OK lens wear in glare. Except for glare and diurnal fluctuations, contact lenses (SCL and OK) were comparable with or superior to spectacle correction.
José F. Alfonso, Luis Fernández-Vega, Carlos Lisa, Paulo Fernandes, Jorge Jorge, and Robert Montés Micó
Ovid Technologies (Wolters Kluwer Health)
PURPOSE: To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount. SETTING: Fernández‐Vega Ophthalmological Institute, Oviedo, Spain. DESIGN: Cohort study. METHODS: Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white‐to‐white (WTW) distance, and lens diameter on postoperative pIOL vault. RESULTS: Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and toric pIOLs, which had a higher mean value and narrower range (260 to 860 μm). Measured vaults had a positive correlation with preoperative ACD (r = .32, P<.001) and WTW (r = .29, P<.001) and a negative correlation with preoperative spherical equivalent (SE) (r = −0.21, P<.001) and patient age (r = −0.12, P=.025). Eyes with a vault of 250 μm or less had a shallower ACD than eyes with a vault between 250 μm and 750 μm (mean difference −0.11 mm; P=.012) and those with a vault greater than 750 μm (mean difference −0.25 mm; P<.001). CONCLUSIONS: Central vaulting was lower in hyperopic eyes. Current nomograms for pIOL diameter selection based on ACD and WTW might yield ideal vault and may have to be adjusted for older patients, shallower ACD, lower WTW, and lower SE. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.
António Queirós, César Villa-Collar, Ángel Ramón Gutiérrez, Jorge Jorge, Maria Sameiro Ribeiro-Queirós, Sofia Claudia Peixoto-de-Matos, and José Manuel González-Méijome
Ovid Technologies (Wolters Kluwer Health)
Purpose: To quantify the changes in the elevation topography of the front and back corneal surfaces after three different refractive treatments for correcting myopia with standard and custom laser in situ keratomileusis (LASIK) and orthokeratology using corneal refractive therapy. Methods: We evaluated 20 eyes undergoing orthokeratology for correction of myopia spherical equivalent (mean±SD=−3.41±0.76 D), 18 eyes undergoing custom LASIK surgery (mean±SD=−4.14±0.89 D), and 23 eyes undergoing standard LASIK (mean±SD=−3.61±0.67 D). The values of front and back corneal surfaces were derived by using Pentacam (Oculus, Inc. GmbH, Wetzlar, Germany) before and at least 3 months after each treatment, in the center of the cornea and 4 points to each side of the horizontal meridian at intervals of 1 mm. Results: Corneal elevation data before treatment were not statistically different between patients in either group (P>0.070, for back and front elevation). After treatment, both surgical procedures significantly increased the positive value of the front elevation beyond an area of 6 mm. The opposite trend was found within the central 5 mm of the cornea, presenting a statistically significant decrease in elevation (P<0.001). In the case of orthokeratology, the elevation experienced a minor but a statistically significant reduction in the central region (P<0.001). On the back surface, the elevation did not undergo statistically significant alterations in any of the procedures and none of the items discussed (P>0.285). Conclusions: Differences in front corneal elevation changes between LASIK and orthokeratology reveal a much different mechanism for producing corneal power subtraction. The back corneal surface does not suffer significant changes after surgical and nonsurgical treatments for the correction of myopia.
Paulo Fernandes, José M. González-Méijome, David Madrid-Costa, Teresa Ferrer-Blasco, Jorge Jorge, and Robert Montés-Micó
SLACK, Inc.
PURPOSE
To review the peer-reviewed literature reporting postoperative complications of the most recent models of Visian Implantable Collamer posterior chamber intraocular lenses (ICL, STAAR Surgical Co).
METHODS
A literature search of the PubMed database was performed to identify all articles related to ICL complications. Articles were obtained and reviewed to identify those that reported complications using the latest ICL designs.
RESULTS
Cataract was the major postoperative complication reported: 136 (5.2%) in 2592 eyes. Of those, 43.4% (n=59) were reported within 1 year, 15.4% (n=21) between 1 and 3 years, and 35.3% (n=48) ≥ 3 years after ICL implantation. Twenty-one (15.4%) cataracts were reported as surgically induced, 46 (33.8%) eyes had poor vault (<200 μm), and cataract surgery was carried out in 27.9% (n=38) of eyes. Early acute intraocular pressure increase was also reported to be relatively frequent, whereas acute pupillary block was less frequent and mostly resolved with additional iridotomies. A total of 42 ICLs were explanted due to cataract and IOP. Reported endothelial cell loss varied from 9.9% at 2 years to 3.7% 4 years postoperatively. This loss was reported to be more pronounced within the first 1 to 2 years, with stability or lower progression after that time.
CONCLUSIONS
The majority of reported complications after ICL implantation are cataract formation. The improvements in lens geometry and more accurate nomograms applied to the selection of the lens to be implanted, in addition to the surgeon's learning curve, might be factors in the decreased occurrence of postoperative complications reported currently.
Javier Ruiz-Alcocer, David Madrid-Costa, Caridad Pérez-Vives, Santiago García-Lázaro, and Jorge Jorge
Future Medicine Ltd
Aim: To evaluate the intraocular pressure (IOP) in the university student population in an urban region in Mozambique using rebound tonometry. Methods: A cross-sectional study with a random selection of students was conducted. IOP was measured after an optometric examination that included uncorrected visual acuity testing, static retinoscopy and subjective refraction without cycloplegia. Refractive error data were converted into spherical equivalent. IOP of the participants was assessed with the Icare® rebound tonometer (Tiolat Oy, Helsinki, Finland). Results: A total of 422 subjects (197 men and 225 women) between 17 and 26 years of age were examined. The mean value of IOP of the whole sample was 14.32 ± 3.30 mmHg. Statistically significant differences in IOP values were not found between men and women (p = 0.564) nor among refractive groups (p = 0.725). Conclusion: Rebound tonometry has been demonstrated to be a convenient and effective method for measuring IOP in this population. Icare can be considere...