Editorial
Standardisation in the methodology and interpretation of the defocus curves and contrast sensitivity in the evaluation of intraocular lenses
Estandarización en la metodología e interpretación de las curvas de desenfoque y la sensibilidad al contraste en el estudio de lentes intraoculares
C. Rocha-de-Lossadaa,
, J.M. Sánchez-Gonzálezb,c, D. Borronid,e, J. Peraza-Nievesa
Corresponding author
a Hospital Clínic de Barcelona, Barcelona, Spain
b Tecnolaser Clinic Vision, Sevilla, Spain
c Departamento de Física de la Materia Condensada, Área óptica, Universidad de Sevilla, Sevilla, Spain
d Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
e Department of Doctoral Studies, Riga Stradins University, Riga, Latvia
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"apellidos" => "Borroni" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Peraza-Nieves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Hospital Clínic de Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Tecnolaser Clinic Vision, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Física de la Materia Condensada, Área óptica, Universidad de Sevilla, Sevilla, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of Doctoral Studies, Riga Stradins University, Riga, Latvia" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estandarización en la metodología e interpretación de las curvas de desenfoque y la sensibilidad al contraste en el estudio de lentes intraoculares" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Defocus curves and contrast sensitivity function (CSF) analysis are used to assess and report visual results of intraocular lenses (IOL). Defocus curves assess visual acuity (VA) at different distances due to the simulation produced by the various defocus lens being applied so that, by changing the vergence, different focus planes are simulated while the patient gazes at a far distance.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> This assessment generally utilizes relative criteria (where the VA limit is related to the level of best achieved VA) or absolute criteria (where the VA limit is independent from the best achieved VA, with 0.3<span class="elsevierStyleHsp" style=""></span>logMAR being the most widely used limit).<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> In 2007, Gupta et al.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> already demonstrated that randomization in lens interposition was necessary to obtain defocus curves in order to avoid the learning effect. In this regard, said authors demonstrated that Weghaupt et al.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> might have overestimated the focal depth of the Array IOL and in addition proposed the necessity of standardizing defocus curves.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Five years later, Buckhurst et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> proposed an assessment of the focus areas in the defocus curves instead of using relative and/or absolute criteria, demonstrating that these areas exhibited a better correlation with the subjective vision of patients. Similarly, said author insisted on the necessity of standardizing defocus curves in order to compare different IOLs on a uniform basis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> We know that CSF is more sensitive to small optical quality changes when compared with VA<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and for this reason it is generally utilized for studying IOLs, particularly multifocal IOLs (mfIOL). However, studies that assessed differences in contrast sensitivity (CS) in different mfIOLs utilized nonstandardized tools for measuring CSF (particularly, studies that utilize CV-10005 and the Functional Acuity Contrast Test [FACT])<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> measuring different spatial frequencies and different lighting conditions (photopic, mesopic and/or scotopic). In addition, CSF only reports results in far gaze and only finds differences at that distance.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,6</span></a> This led to the development of contrast sensitivity defocus curves that measure CS at different distances.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The scientific community is fully aware of the importance of methods in any clinic study and the significance of the fact that said studies clearly described the methodology used to conduct their research for replication by subsequent researchers and/or academics. However, despite the recommendations of Buckhurst et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> and Gupta et al.,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> we continue to find studies that do not fulfill standardized criteria<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> that provide new knowledge to the scientific community but do not contribute information about their methodology<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> or assess VA and defocus curves but not CSF.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Even more, studies that assess CSF and VA but without applying defocus curves.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> We believe that the utilization of new devices such as the Multifocal Lens Analyzer<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> that systematically utilizes a randomized sequence of letters, focus areas and measures a specific defocus range (+1.00 to −4.00<span class="elsevierStyleHsp" style=""></span>D) and in addition enables the measurement of VA defocus curves as well as distance contrast sensitivity curves, diminishing in this way the time required by the test from 20–30<span class="elsevierStyleHsp" style=""></span>min to 8–10<span class="elsevierStyleHsp" style=""></span>min. This could be a starting point to establish a protocol for carrying out defocus curves. We also understand that other systems that standardized contrast sensitivity studies and allow the study of several frequencies at several distances, unnecessary in order to obtain standardized protocols for interpreting visual results of IOLs, particularly mfIOLs. We propose is that the scientific community should set up a protocol for conducting and reporting defocus and contrast sensitivity curves in scientific studies. We also recommend measuring both curves always in a uniform manner and under the same conditions.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">No funding has been received for the preparation of this paper.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rocha-de-Lossada C, Sánchez-González JM, Borroni D, Peraza-Nieves J. Estandarización en la metodología e interpretación de las curvas de desenfoque y la sensibilidad al contraste en el estudio de lentes intraoculares. 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| 2023 March | 1 | 0 | 1 |
