July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Crystalline lens accommodation through multifocal corrections
Author Affiliations & Notes
  • Geethika Muralidharan
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Judith Birkenfeld
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Maria Vinas
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Andrea Curatolo
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Eduardo Martinez-Enriquez
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Alberto De Castro
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Susana Marcos
    Instituto de Óptica "Daza de Valdés" (IO-CSIC), Madrid, Madrid, Spain
  • Footnotes
    Commercial Relationships   Geethika Muralidharan, None; Judith Birkenfeld, None; Maria Vinas, None; Andrea Curatolo, None; Eduardo Martinez-Enriquez, EP15382106 (WO2016142490A1) (P); Alberto De Castro, None; Susana Marcos, EP15382106 (WO2016142490A1) (P), US20170316571A1​ (P)
  • Footnotes
    Support  European Research Council (ERC) under European Union’s Horizon 2020 research and innovation programme H2020-MSCA-ITN-2015-675137,Spanish government grant FIS2014-56643-R, Spanish government grant FIS2017-84753-R, European Research Council under the European Union’s Seventh Framework Programme ERC-2011-AdG-294099​
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1803. doi:https://doi.org/
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      Geethika Muralidharan, Judith Birkenfeld, Maria Vinas, Andrea Curatolo, Eduardo Martinez-Enriquez, Alberto De Castro, Susana Marcos; Crystalline lens accommodation through multifocal corrections. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1803. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Multifocal contact lenses have been shown to slow the progression of myopia by mechanisms related to the increase of peripheral defocus or reduction of accommodative error. We evaluated the effect of multifocal designs on the accommodative response of myopes by measuring changes in the crystalline lens geometry.

Methods : A custom-developed 3-D spectral Optical Coherence Tomography (sOCT) system, provided with automatic quantification and distortion correction algorithms was used to characterize the anterior eye segment of myopic subjects (n=4, age=26.8±2.87 SE:-0.75 to -2.75D). A Badal optometer allowed refraction correction and accommodation stimulation (0, 2 and 4 D) to an E-letter stimulus. Free-form lathed bifocal phase-plates (6-mm pupil, 50 far/50 near, +3 D add) were incorporated to the system by a relay of lenses and inserted onto the pupil plane. Two multifocal designs were tested: (1) concentric center distance (CCD), and (2) asymmetric upper distance (AUD). Changes in lens thickness (LT) and radius of curvature (for anterior Ra and posterior Rp lens) and pupil diameter (Pd) were evaluated for different accommodative effort (AE) without (Nat) and with multifocal designs

Results : The crystalline lens underwent accommodative changes in all conditions: under Nat, LT increased by 0.28±0.06 mm, Pd decreased by -1.51±0.95 mm, and Ra and Rp decreased -3.1±1.6 mm and -0.63±0.27 mm, over 4 D AE range. Changes over 0-2 D AE were consistently higher than in 2-4 D (by 39% in LT & 167% in Ra). Accommodative changes in the crystalline lens LT were higher for Nat (0.065 mm/D) than for CCD (0.031 mm/D) and AUD (0.04 mm/D), in the 2-4 D, and changes in Ra were higher in Nat (-0.77 mm/D) than for CCD (-0.70 mm/D) and AUD (-0.69 mm/D), in 0-4D range.

Conclusions : Changes in crystalline lens morphology provide a direct assessment of the response to an accommodative effort. Bifocal lenses with various near/far pupillary distributions do not prevent young subjects to stop accommodating. However, reduced rates of change in lens thickness and curvature suggest that subjects make use of near add for near vision, to some extent, with the effect likely influenced by the specific distribution of near/distance zones.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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