Standardization for reporting medical outcomes facilitates clinical study comparisons and has a fundamental role on research reproducibility. In this context, we present AstigMATIC, a free standalone application for automated standardized astigmatism vector analyses in corneal and intraocular refractive surgeries. AstigMATIC uses a simple graphical user interface (GUI) and allows the simultaneous display and analysis of astigmatism magnitude and axis. The software produces the four following standard graphs according to the standards of the Alpins Method; 1-Target-Induced Astigmatism Vector, 2-Surgically-Induced Astigmatism Vector, 3-Difference Vector and 4-Correction Index. Vector means with X and Y standard deviations are automatically calculated and displayed on the corresponding single-angle vector plots (0 to 180°). Data points are entered into a simplified GUI with no need for command line input. The standard graphs can be easily exported as high-resolution TIFF images for figures to use in production and presentations. AstigMATIC software enables the user to easily and efficiently analyze vectorial astigmatism outcomes using the standardized Alpins Method for post-surgical astigmatism. AstigMATIC and the demonstration datasets are available to download from http://www.lasikmd.com/media/astigmatic .

Purpose. To compare time domain (TD: peak time and amplitude) analysis of the human photopic electroretinogram (ERG) with measures obtained in the frequency domain (Fourier analysis: FA) and in the time-frequency domain (continuous (CWT) and discrete (DWT) wavelet transforms).Methods. Normal ERGsn=40were analyzed using traditional peak time and amplitude measurements of the a- and b-waves in the TD and descriptors extracted from FA, CWT, and DWT. Selected descriptors were also compared in their ability to monitor the long-term consequences of disease process.Results. Each method extracted relevant information but had distinct limitations (i.e., temporal and frequency resolutions). The DWT offered the best compromise by allowing us to extract more relevant descriptors of the ERG signal at the cost of lesser temporal and frequency resolutions. Follow-ups of disease progression were more prolonged with the DWT (max 29 years compared to 13 with TD).Conclusions. Standardized time domain analysis of retinal function should be complemented with advanced DWT descriptors of the ERG. This method should allow more sensitive/specific quantifications of ERG responses, facilitate follow-up of disease progression, and identify diagnostically significant changes of ERG waveforms that are not resolved when the analysis is only limited to time domain measurements.

To provide a simplified method to optimize lens constants to zero the mean prediction error (ME) of an intraocular lens (IOL) calculation formula, without the need to program the formula itself, by exploring the influence of IOL and corneal power on the refractive impact of variations in effective lens position. Theoretical development of an optimized formula and retrospective clinical evaluation on documented datasets. Retrospective data from 8878 patients with cataracts with pre- and postoperative measurements available using 4 IOL models and 6 IOL power calculation formulas were examined. A schematic eye model was used to study the impact of small variations in effective lens position (ELP) on the postoperative spherical equivalent (SE) refraction. The impact of keratometry (K) and IOL power (P) on SE was investigated. A theoretical thick lens model was used to devise a formula to zero the average prediction error of an IOL power calculation formula. This was achieved by incrementing the predicted ELP, which could then be translated into an increment in the IOL constant. This method was tested on documented real-life postoperative datasets, using different IOL models and single-constant optimized IOL calculation formulas. For small variations in ELP, there was an exponential relationship between IOL power and the resultant postoperative refractive variation. The ELP adjustment necessary to zero the ME equated to a ratio between the ME and the mean of the following expression: 0.0006^*(P²+2K^*P) on the considered datasets. The accuracy of the values obtained using this formula was confirmed on documented postoperative datasets, and on published and nonpublished formulas. The proposed method allows surgeons without special expertise to optimize an IOL constant to nullify the ME on a documented dataset without coding the different formulas. The influence of individual eyes is proportional to the squared power of the implanted IOL.

Background: Standardization for reporting medical outcomes enables clinical study comparisons and has a fundamental role in research reproducibility. In this context, we present mEYEstro, a free novel standalone application for automated standardized refractive surgery graphs. mEYEstro can be used for single and multiple group comparisons in corneal and intraocular refractive surgery patients. In less than 30 s and with minimal user manipulation, mEYEstro automatically creates the required journal standard graphs while simultaneously performing valid statistical analyses. Results: The software produces the following 11 standard graphs; Efficacy: 1. Cumulative uncorrected (UDVA) and corrected visual acuity (CDVA), 2. Difference between UDVA and CDVA, Safety: 3. Change in line of CDVA, Accuracy: 4. Spherical equivalent (SEQ) to intended target, 5. Attempted vs. achieved SEQ, 6. Defocus equivalent (DEQ) accuracy, 7. Refractive astigmatism accuracy, 8. Target-induced astigmatism vs. Surgically-induced astigmatism, 9. Correction index histogram, 10. Angle of error histogram, Stability: 11. SEQ stability over time. Percent proportions, means, standard deviations, Cohen's d effect sizes, and p-values are calculated and displayed on each graph. All graphs can be easily exported as high-resolution TIFF images for figures to use in scientific manuscripts and presentations. Conclusions: mEYEstro software enables clinicians, surgeons, and researchers, to easily and efficiently analyze refractive surgery outcomes using the standardized methodology required by several peer-reviewed ophthalmology journals.

Purpose: Discrete wavelet transform (DWT) analyses suggest that the 20- and 40-Hz components of the short-flash photopic electroretinogram (ERG) are closely related to the ON and OFF pathways, respectively. With the DWT, we examined how the ERG ON and OFF components are modulated by the stimulus intensity and/or duration. Methods: Discrete wavelet transform descriptors (20, 40 Hz and 40:20-Hz ratio) were extracted from ERGs evoked to 25 combinations of flash durations (150–5 ms) and strengths (0.8–2.8 log cd.m⁻²). Results: In ERGs evoked to the 150-ms stimulus (to separate the ON and OFF ERGs), the 40:20-Hz ratio of ON ERGs (mean ± SD: 0.49 ± 0.04) was significantly smaller (P < 0.05) than that of OFF ERGs (1.71 ± 0.18) owing to a significantly (P < 0.05) higher contribution of the 20 and 40 Hz components to the ON and OFF ERGs, respectively. With brighter stimuli, the ON and OFF components increased similarly (P < 0.05). While progressively shorter flashes had no impact (P > 0.05) on the ON component, it exponentially enhanced (P < 0.05) the OFF component. Conclusions: Discrete wavelet transform allows for an accurate determination of ON and OFF retinal pathways even in ERGs evoked to a short flash. To our knowledge, the significant OFF facilitatory effect evidenced with shorter stimuli has not previously been reported. Translational Relevance: The DWT approach should offer a rapid, easy, and reproducible approach to retrospectively and prospectively evaluate the function of the retinal ON and OFF pathways using the standard (short-flash duration) clinical ERG stimulus.