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21 protocols using lenstar

1

Visual Acuity and Ocular Biometrics

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Twenty participants, ages 22 to 45 years, were enrolled in this study. The study was approved by the institutional review board at the University of Houston and procedures followed the tenets of the Declaration of Helsinki. Informed consent was obtained after the purpose and risks of the study were explained.
Visual acuity was measured with the participant's habitual correction. All participants had a best corrected visual acuity of 20/25 or better. Non-cycloplegic autorefraction was measured for both eyes (WAM-5000; Grand Seiko, Tokyo, Japan). Axial length and central corneal thickness were measured using a non-contact low-coherence optical biometer (LenStar; Haag-Streit, Köniz, Switzerland). Five measurements were collected and averaged for each eye. Exclusion criteria included any ocular pathology, use of prescription or over-the-counter medications known to affect sleep or circadian rhythms, use of sleep aids such as melatonin, and shift work or travel across more than two time zones during the month prior to the study visit. No participants had any systemic disease with ocular manifestations, such as diabetes or hypertension.
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2

Comprehensive Ophthalmic Measurements Protocol

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All patients underwent a complete ophthalmologic measurement. Visual acuity included uncorrected and corrected distance visual acuity (UDVA and CDVA) and uncorrected and corrected near visual acuity (UNVA and CNVA). Biometry, such as axial length, WTW, and CCT, was performed using a Lenstar noncontact optical low-coherence reflectometer (LS900; Haag-Streit, Koniz, Switzerland). Corneal volume (CV) and TCA were obtained using a Pentacam (70700, Oculus, Wetzlar, Germany). Anatomic landmarks of the eye were obtained using the Verion Image-Guided System (Alcon Laboratories, Inc., Fort Worth, TX, America).
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3

Pupil Dynamics Under Mydriasis

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Each subject underwent two experimental sessions. At the first visit, spherical equivalent refraction was calculated for each eye following non-cycloplegic autorefraction (WAM-5000, Grand Seiko, Japan), and axial length and pupil diameter were determined (LenStar, Haag-Streit, Germany). Following these measures, non-mydriatic pupillometry was performed. For pupillometry, stimuli were presented to the left eye, and the consensual pupil response was measured in the right eye. The left eye was then dilated with either 2.5% phenylephrine (Paragon BioTeck, Inc, Portland, OR) or 0.5% atropine (Greenpark Compounding Pharmacy, Houston, TX, USA). An atropine concentration of 0.5% was chosen to minimize recovery time between visits whilst still eliciting a significant effect on the pupil. The pharmacological agent used at the first session was randomized. Two drops of the selected mydriatic were delivered five minutes apart to the left eye. After a 45-minute dilation period, diameter of the dilated left pupil was measured, and pupillometry was repeated. To allow drug wash-out, visit two was scheduled at least five days later if phenylephrine 2.5% had been instilled first, and at least ten days later if atropine 0.5% had been instilled first.
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4

Refractive Outcomes of Combined Procedures

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The main outcome measures in the study were refractive outcomes, specifically the difference between target spherical equivalent (SE) and postsurgery SE between 1 and 3 months, as well as the difference in astigmatism pre- and postsurgery. Preoperative astigmatism was collected by dual-zone keratometry (Lenstar; Haag-Streit, Berne, Switzerland). Postoperative astigmatism was determined by manifest refraction. Intraocular lenses used in each of the two groups were recorded. Secondary outcome measures for the combined group included IOP and number of glaucoma medications. Notably, combination medications were reported as two medications. Preoperative IOP was obtained in the visit immediately prior to surgery and based on a single measure.
Preoperative data were used to establish a baseline, which typically occurred in the visit immediately before surgery. Postoperatively, data were collected from the following time points to compare with baseline data: 1 day, 1 week, 1 month, 3 months, and 6 months. At each time point, the data collected included IOP, number, and type of medications used, and manifest refraction was obtained at certain time points.
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5

Comprehensive Examination Protocol for Diabetes

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All participants underwent a standardized questionnaire, physical and ocular examinations at baseline and each follow-up examination using the same study protocol. A standardized questionnaire was used by a trained interviewer to collect information of age, duration of diabetes, systemic chronic diseases and ocular disease, medication usage and history of systemic and ocular surgery. A brief questionnaire of self-reported change in chronic disease status (disease and medicine) was also conducted at each follow-up. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measure using a digital BP monitor (Hem-907, Omron, Kyoto, Japan) by the same trained personnel. Venous blood samples were collected to assess total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides (TG), serum creatinine (Scr) and hemoglobin A1c (HbA1c) by standardized methods. All participants underwent detailed ocular examination followed standard protocol, including uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), non-cycloplegic refractions (KR8800; Topcon, Tokyo, Japan), ocular biometry (Lenstar, LS900, Haag-Streit, Koeniz, Switzerland) and non-contact tonometer (CT-1, Topcon, Tokyo, Japan).
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6

Cycloplegic Refraction Measurement Protocol

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Measures of AL were conducted on each eye prior to cycloplegia using an IOL-Master (Carl Zeiss 500/700, Meditec, Oberkochen, Germany), Lenstar (Lenstar LS-900, Haag-Streit AG, Koeniz, Switzerland), or Nidek AL-Scan (Nidek Co., LTD., Tokyo, Japan) depending on the biometry devices that were available and used in each specific hospital. It was mandated that the same device used at baseline for each participant was to be used at follow-up. Cycloplegia was conducted using two drops of 0.5% tropicamide 5 min apart, three times before autorefraction. A pupil size of more than 6 mm and/or the light reflex being absent was considered fully dilated. Autorefraction was measured in each eye using Topcon KR-8800 (Topcon, Tokyo, Japan) or Nidek ARK-900 (Nidek Co., LTD., Tokyo, Japan), and three readings in each eye were taken and averaged until the desired precision (0.25 D for spherical and cylinder power, 5° for axis) was achieved. Cycloplegic spherical equivalent refraction (SER) was defined as the spherical degree plus half of the cylindrical degree.
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7

Ocular Biometry in Healthy Adults

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Twenty participants, ages 23–46 years, were included in this study. All had best corrected visual acuity of logMAR 0.0 (6/6) or better with their habitual correction. Exclusion criteria were any ocular pathology, systemic disease with ocular manifestations, such as diabetes or hypertension or the use of photochromic lenses or blue blocking filters in their habitual correction. Non-cycloplegic autorefraction was measured for both eyes (WAM-5000; Grand Seiko, grandseiko.com). Axial length was measured using a non-contact low-coherence optical biometer (LenStar; Haag-Streit, haag-streit.com). For autorefraction and biometry, five measurements were collected and averaged for each eye. The study was approved by the Institutional Review Board at the University of Houston and procedures followed the tenets of the Declaration of Helsinki. Informed consent was obtained after the purpose and risks of the study were explained.
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8

Noncontact Ocular Biometry with Lenstar

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The noncontact ocular biometry Lenstar (LS900; Haag-Streit, Koniz, Switzerland) calculates ocular distances by the effect of time domain interferometric or coherent superposition of light waves. It is based on optical low-coherence reflectometry using a 20~30 nm broadband light source with an 820 nm center wavelength. The patients seated with his or her chin on a chin rest and pressed their forehead against the forehead strap. The Lenstar was focused and aligned using eye images on the computer monitor while the patients were asked to fixate straight ahead on an internal fixation light. The mean value of those measurements was automatically calculated by the instrument software. The eccentricity of the visual optical line was assessed according to the distance of the visual axis and the pupil center. Angle kappa was calculated using the X and Y coordinates of the pupil barycenter (pupil dx, pupil dy) (Figure 1, B). Pupil dx indicates the x coordinate of the pupil center relative to the corneal apex, and pupil dy indicates the y coordinate of the pupil center relative to the corneal apex. The size of the angle kappa was calculated using the formula r = (X2 +Y2) 1/2.
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9

Ocular Imaging and Pupillometry Protocol

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Before the ocular imaging measurements for each condition, subjects first underwent a 10-minute distance viewing period to minimize effects of prior ocular accommodation and physical activity. During this time, subjects viewed a television at 4 m under an illumination of 60 lux measured in the vertical plane at eye level (LX1330B; Dr. Meter, Union City, CA). Ocular imaging was then performed using spectral domain optical coherence tomography (SD-OCT; Spectralis, Heidelberg, Germany). Two high-quality images (signal strength >35 dB) of the back of the right eye were collected. The scan protocol included a six-line 30° radial scan centered at the fovea (Fig. 1). For each subject, the first image at the first visit was set as the reference for subsequent imaging. Then, the axial length was measured for the right eye using a noncontact low-coherence optical biometer (LenStar, Haag-Streit, Köniz, Switzerland). Five measurements were collected and averaged. Axial length was measured as a correlate to choroidal thickness; previous studies have shown that short-term fluctuations in choroidal thickness are accompanied by fluctuations in axial length in the opposite direction.25 (link)27 (link) After these measurements, nonmydriatic pupillometry was performed (Fig. 2A).
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10

Biometric Measurements for AOSLO Imaging

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Biometric measurements of axial length, anterior chamber depth, lens thickness, and anterior corneal curvature were acquired from right and left eyes of each animal (LenStar; Haag-Streit, Köniz, Switzerland). These biometric parameters were used to convert field sizes in adaptive optics scanning laser ophthalmoscope (AOSLO) images from visual angle (in degrees) to physical retinal size (in micrometers). Conversions were performed by incorporating the measured biometry data into a four-surface model eye.34 (link),35 (link)
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