(1) The document summarizes research using an Adaptive Optics Vision Analyzer (AOVA) to evaluate the visual quality and potential limitations of a corneal inlay with a pinhole aperture. (2) The AOVA was able to successfully implement a simulated corneal inlay and test its depth of focus under different lighting conditions, as well as the effects of misalignment and a pupil larger than the inlay. (3) Key findings include the inlay extending depth of focus over 1 diopter under low light, high tolerance for misalignment with monochromatic light but reduced tolerance with white light, and distant vision most affected if pupil surpasses inlay size.

1. WHY A PINHOLE?
Visual Quality with a Corneal Inlay with an
Adaptive Optics Vision Analyzer (AOVA)
Guillermo M. Pérez, PhD.
Sevilla Refractiva 2013

2. The AcuFocus Corneal Inlay

3. Advantages
• simple operating principle
• relatively simple for practical implementation
Possible disadvantages?
• reduction in amount of light reaching retina
• misalignments
• natural pupil could become larger than outer
inlay diameter

4. Evaluating the potential and limitations of
the small aperture inlay by using
Adaptive Optics Vision Analyzer
(AOVA)

5. Adaptive Optics Vision Analyzer
LCOS Micro-display
(spatial light modulator) H-S IR LED
Voptica visual
smart optics

6. AOVA
H-S
LCOS

7. Binocular AOVA LCoS-SLM
(reflection)
IR
HSS
Micro- LC-SLM
projector (transmission)
subject

8. A real inlay vs a simulated inlay
in the same subject (CvP)
E
OD OS

9. Through-focus performance
of the small aperture under different
conditions: mono/binocular; luminance…
3 subjects
ND 1.5
E
E
photopic mesopic
conditions conditions

10. Photopic conditions
E
OD OS

11. Mesopic conditions
E
OD OS

12. Effect of aperture decentration
non-dominant eye of
3 subjects
E

13. Strehl-Ratio for
Strehl-Ratio for
E
monochromatic
polychromatic
light (550nm)
light
nasal temporal
J Cataract Refract Surg 2012; 38:270–277

14. Simulating a corneal inlay
in case the subject’s natural pupil becomes larger
than the outer inlay diameter
non-dominant eye of 3
subjects
E

15. E

16. In summary…
• The small-aperture inlay was successfully implemented in a
binocular adaptive optics vision analyzer. The system could be
used for pre-screening or personalized treatments.
• The corneal small aperture inlay extends depth of focus by
more than 1 D, even under mesopic luminance conditions.
• For monochromatic light, a high tolerance for visual acuity
towards horizontal misalignments of the inlay was observed.
However, in white light this should be notably reduced due to
the impact of lateral chromatic aberration.
• In the case that the natural pupil surpasses the outer inlay
diameter, mainly distant vision is affected.

17. Thanks for
your attention
Guillermo M. Pérez, PhD.