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First Author: FrancSalamun SLOVENIA
Co Author(s): Claes Feinbaum Katja Matovic Sudi Patel
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Purpose: To determine if a) uncorrected distance (UDVA) and near acuity (UNVA) and, b) clinical depth of field (DoF) can be improved by topical administration of drops inducing changes in pupil size in presbyopic eyes with low distance prescriptions.
: Medicinski Center Vid, Slovenia & Vision4You, Lund, Sweden
UDVA was measured using a standard LogMAR chart, UNVA was measured using standard near chart at 40cm. DoF, at distance was measured by asking the patient to look at smallest letter with the best correction. Firstly, plus (a) lenses were racked up on the refractor head until the patient reported quality of vision was unacceptable. This was repeated using minus lenses (b). Irrespective of lens sign, DoF = a+b. Mesopic pupil size was measured by infra-red pupillometry. Two drops of a custom made topical medication (consisting of an NSAID, an ocular lubricant and parasympathomimetic) were instilled and measurements were repeated 30-45 minutes later. All subjects were presbyopes (50 eyes, age range 42-57 years). All acuity values were converted to decimal notation.
Reporting just the significant association (p=<0.001) encountered in the 50 cases. The mean before (i) and after (ii) findings were: 1) Depth of Field (i) 1.35D, (ii) 1.93D 2) Pupil size (i) 2.75mm, (ii) 2.13mm 3) UDVA (i) 1.12, (ii) 1.29 4) UNVA (i) 0.39, (ii) 0.60 A significant correlation between each change in pupil size and change in DoF was detected.
In this cohort of cases, both UNVA and UDVA improved after drop instillation. Converting to Jaeger categorisation, the results show that it is possible for the intervention to improve UNVA from J6 to J4. Reducing pupil size was strongly associated with a rise in DoF and improvement in both distance and near acuity. By extrapolation, a one mm reduction in pupil size was associated with an increase in depth of field of 0.94D in presbyopic eyes. FINANCIAL INTEREST: ... gains financially from product or procedure presented