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This study aims to evaluate the applicability of the high-resolution WaveFront Phase Imaging Sensor (WFPI) in eyes with Fuchs' Endothelial Corneal Dystrophy (FECD) through qualitative and quantitative analysis using a custom-designed Automatic Guttae Detection Method (AGDM). The ocular phase was measured using the t · eyede aberrometer and then was processed to obtain its High-Pass Filter Map (HPFM). The subjects were pathological and healthy patients from the Fundación Jiménez-Díaz Hospital (Madrid, Spain). The AGDM was developed and applied in pupils with 3 and 5 mm of diameter. A set of metrics were extracted and evaluated like the Root-Mean-Square error (RMS), Number of guttae, Guttae Area, and Area of Delaunay Triangulation (DT). Finally, a Support Vector Machine (SVM) model was trained to classify between pathological and healthy eyes. Quantitatively, the HPFM reveals a dark spots pattern according to the ophthalmologist's description of the slit-lamp examination of guttae distribution. There were significant statistical differences in all the metrics when FECD and Healthy groups were compared using the same pupil size; but comparing both pupil sizes for the same group there were significant differences in most of the variables. This sensor is a value tool to objectively diagnose and monitor this pathology through wavefront phase changes.

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Refractive surgery has experienced substantial advancements over the past few years, driven by innovative techniques and continuous technological progress aimed at enhancing visual outcomes and patient satisfaction. Refractive errors such as myopia, hyperopia, and astigmatism affect a significant portion of the global population, impacting quality of life and productivity. Recent advancements have been fueled by a deeper understanding of ocular biomechanics and visual optics, leading to more precise and effective treatments. Traditional methods such as LASIK and PRK have been refined, and new procedures like SMILE (Small Incision Lenticule Extraction) have been introduced, expanding the range of treatable refractive errors and improving safety and predictability. Customized treatments, such as wavefront-guided LASIK and topography-guided PRK, allow for individualized plans tailored to each patient's unique corneal characteristics, enhancing visual acuity and reducing higher-order aberrations. The use of femtosecond lasers in procedures like Femto-LASIK and femtosecond laser-assisted cataract surgery (FLACS) offers unparalleled precision, reducing surgical risks and improving outcomes. Implantable Collamer Lenses (ICLs) and corneal crosslinking (CXL) have emerged as effective options for specific patient groups. Advanced diagnostic tools like optical coherence tomography (OCT) and Scheimpflug imaging have improved surgical planning and complication management. As research and technology continue to evolve, these advancements promise even greater improvements in refractive surgery, addressing the visual needs of the global population.

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BACKGROUND: Phase-contrast computed tomography (CT) using high-brilliance, synchrotron-generated x-rays enable three-dimensional (3D) visualization of microanatomical structures within biological specimens, offering exceptionally high-contrast images of soft tissues. Traditional methods for phase-contrast CT; however, necessitate a gap between the subject and the x-ray camera, compromising spatial resolution due to penumbral blurring. Our newly developed technique, Superimposed Wavefront Imaging of Diffraction-enhanced x-rays (SWIDeX), leverages a Laue-case Si angle analyzer affixed to a scintillator to convert x-rays to visible light, capturing second-order differential phase contrast images and effectively eliminating the distance to the x-ray camera. This innovation achieves superior spatial resolution over conventional methods. PURPOSE: In this paper, the imaging principle and CT reconstruction algorithm based on SWIDeX are presented in detail and compared with conventional analyzer-based imaging (ABI). It also shows the physical setup of SWIDeX that provides the resolution preserving second-order differential images for reconstruction. We compare the spatial resolution and the sensitivity of SWIDeX to conventional ABI. METHODS: To demonstrate high-spatial resolution achievable by SWIDeX, the internal structures of four human tissues-ductal carcinoma in situ, normal stomach, normal pancreas, and intraductal papillary mucinous neoplasm of the pancreas-were visualized using an imaging system configured at the Photon Factory's BL14B beamline under the High Energy Accelerator Research Organization (KEK). Each tissue was thinly sliced after imaging, stained with hematoxylin and eosin (H&E) for conventional microscope-based pathology. RESULTS: A comparison of SWIDeX-CT and pathological images visually demonstrates the effectiveness of SWIDeX-CT for biological tissue imaging. SWIDeX could generate clearer 3D images than existing analyzer-based phase-contrast methods and accurately delineate tissue structures, as validated against histopathological images. CONCLUSIONS: SWIDeX can visualize important 3D structures in biological soft tissue with high spatial resolution and can be an important tool for providing information between the disparate scales of clinical and pathological imaging.

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We characterize the subsurface thermal degradation of an inert analog of high-explosive molecular crystals (Eu:Y(acac)3(DPEPO)) (EYAD) embedded inside of a plastic bonded explosive simulant using feedback-assisted wavefront shaping-based fluorescence and Raman spectroscopies. This technique utilizes wavefront shaping to focus pump light inside a heterogeneous material onto a target particle, which significantly improves its spectroscopic signature. We find that embedding the EYAD crystals in the heterogeneous polymer results in improved thermal stability, relative to bare crystal measurements, with the crystal remaining fluorescent to >612 K inside of the heterogeneous material, while the bare crystal's fluorescence is fully quenched by 500 K. We hypothesize that this improvement is due to the polymer restricting the effects of EYAD melting, which occurs at 400 K and is the primary mechanism for spectroscopic changes in the temperature range explored.

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Purpose: To compare the visual quality after wavefront-guided femtosecond LASIK (WFG FS-LASIK) in patients with different levels of preoperative total ocular higher-order aberrations to guide clinical decision-making regarding patient selection and treatment strategies. Methods: This study included 112 right eyes of 112 patients who previously underwent WFG FS-LASIK for correcting myopia and myopic astigmatism. The patients were divided into two groups based on the mean values of preoperative total ocular HOAs (0.30 ± 0.09 µm): HOA ≤ 0.3 and > 0.3 groups. The visual acuity, manifest refraction, corneal Strehl ratio (SR), root mean square (RMS) of corneal and ocular aberrations, and area under the log contrast sensitivity function (AULCSF) of both groups were compared preoperatively and at 1, 3, 6, and 12 months postoperatively. Results: The induced ocular HOAs and coma (Δ = 1 mo - Preop) were significantly lower in the HOAs > 0.3 group than in the HOAs ≤ 0.3 group (ΔHOAs: 0.39 ± 0.19 vs. 0.29 ± 0.18 µm, t = 2.797, P = 0.006; Δ coma: 0.30 ± 0.19 vs. 0.20 ± 0.21 µm, t = 2.542, P = 0.012). In the HOAs > 0.3 group, ΔHOAs were negatively correlated with the preoperative ocular HOAs (r = -0.315, P = 0.019). In the HOAs ≤ 0.3 group, the regression equation for Δ HOAs = 0.098 + 0.053 |SE| (F = 21.756, P < 0.001). In the HOAs > 0.3 group, the regression equation for ΔHOAs = 0.534 - 1.081 HOAs + 0.038|Sphere| (F = 7.954, P = 0.001). The postoperative uncorrected distance visual acuity, spherical equivalent, corneal aberrations, SR and AULCSF of both groups were similar (all P > 0.05). Furthermore, the ocular aberrations were not significantly different between both groups at 3, 6, and 12 months postoperatively (all P > 0.05). In addition, compared with the preoperative period, the AULCSF of both groups were significantly increased in the postoperative period (all P < 0.05). Conclusions: The induced ocular HOAs and coma in HOAs > 0.3 group were lower. However, both groups achieved equivalent and excellent visual quality after WFG FS-LASIK. WFG FS-LASIK may provide significant visual benefits for a wider range of patients.

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Modeling the behavior of a prototype cantilevered X-ray adaptive mirror (held from one end) demonstrates its potential for use on high-performance X-ray beamlines. Similar adaptive mirrors are used on X-ray beamlines to compensate optical aberrations, control wavefronts and tune mirror focal distances at will. Controlled by 1D arrays of piezoceramic actuators, these glancing-incidence mirrors can provide nanometre-scale surface shape adjustment capabilities. However, significant engineering challenges remain for mounting them with low distortion and low environmental sensitivity. Finite-element analysis is used to predict the micron-scale full actuation surface shape from each channel and then linear modeling is applied to investigate the mirrors' ability to reach target profiles. Using either uniform or arbitrary spatial weighting, actuator voltages are optimized using a Moore-Penrose matrix inverse, or pseudoinverse, revealing a spatial dependence on the shape fitting with increasing fidelity farther from the mount.

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Advances in physics have been significantly driven by state-of-the-art technology, and in photonics and X-ray science this calls for the ability to manipulate the characteristics of optical beams. Orbital angular momentum (OAM) beams hold substantial promise in various domains such as ultra-high-capacity optical communication, rotating body detection, optical tweezers, laser processing, super-resolution imaging etc. Hence, the advancement of OAM beam-generation technology and the enhancement of its technical proficiency and characterization capabilities are of paramount importance. These endeavours will not only facilitate the use of OAM beams in the aforementioned sectors but also extend the scope of applications in diverse fields related to OAM beams. At the FERMI Free-Electron Laser (Trieste, Italy), OAM beams are generated either by tailoring the emission process on the undulator side or, in most cases, by coupling a spiral zone plate (SZP) in tandem with the refocusing Kirkpatrick-Baez active optic system (KAOS). To provide a robust and reproducible workflow to users, a Hartmann wavefront sensor (WFS) is used for both optics tuning and beam characterization. KAOS is capable of delivering both tightly focused and broad spots, with independent control over vertical and horizontal magnification. This study explores a novel non-conventional `near collimation' operational mode aimed at generating beams with OAM that employs the use of a lithographically manufactured SZP to achieve this goal. The article evaluates the mirror's performance through Hartmann wavefront sensing, offers a discussion of data analysis methodologies, and provides a quantitative analysis of these results with ptychographic reconstructions.

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Fluorescent dye films on transparent substrates are essential for OLEDs, flexible displays, X-ray detection, and wireless optical communications. However, their efficiency is often hampered by fluorescence trapping due to total internal reflection (TIR) and waveguiding. This study tackles this longstanding challenge by reconceptualizing the integration of dye films with nanoantenna metasurfaces. Traditional methods involve directly spin-coating films onto c-Si metasurfaces on quartz substrates, resulting in edge luminescence and weak inner signals. We present a straightforward, adjustable approach by integrating dye films on the opposite side of quartz substrates, reaching a 2.5-fold photoluminescence enhancement and improving the uniformity of the emission compared to the conventional methods. These gains stem from redirecting a significant portion of leaked fluorescence light trapped inside the substrate into free space, surpassing TIR conditions through in-plane diffraction orders of the metasurfaces across the full RGB spectrum. Our findings facilitate the design of more efficient luminescent devices.

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Accurate segmentation of the pulmonary airway tree is crucial for diagnosing lung diseases. To tackle the issues of low segmentation accuracy and frequent leaks in existing methods, this paper proposes a precise segmentation method using quasi-spherical region-constrained wavefront propagation with tracheal wall gap sealing. Based on the characteristic that the surface formed by seed points approximates the airway cross-section, the width of the unsegmented airway is calculated, determining the initial quasi-spherical constraint region. Using the wavefront propagation method, seed points are continuously propagated and segmented along the tracheal wall within the quasi-spherical constraint region, thus overcoming the need to determine complex segmentation directions. To seal tracheal wall gaps, a morphological closing operation is utilized to extract the characteristics of small holes and locate low-brightness tracheal wall gaps. By filling the CT values at these gaps, the method seals the tracheal wall gaps. Extensive experiments on the EXACT09 dataset demonstrate that our algorithm ranks third in segmentation completeness. Moreover, its performance in preventing airway leaks is significantly better than the top-two algorithms, effectively preventing large-scale leak-induced spread.

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Ultrasound shear wave elastography is an imaging modality that noninvasively assesses mechanical properties of tissues. The results of elastic imaging are obtained by accurately estimating the propagation velocity of shear wave fronts. However, the acquisition rate of the shear wave acquisition device is limited by the hardware of the system. Therefore, increasing the collection rate of shear waves can directly improve the quality of shear wave velocity images. In addition, the problem of velocity reconstruction with relatively small elastic inclusions has always been a challenge in elastic imaging and a very important and urgent issue in early disease diagnosis. For the problem of elastography detection of the shape and boundary of inclusions in tissues, Time-sharing latency excitation frame composite imaging (TS-FCI) method is proposed for tissue elasticity measurement. The method fuses the shear wave motion data generated by time sharing and latency excitation to obtain a set of composite shear wave motion data. Based on the shear wave motion data, the local shear wave velocity image is reconstructed in the frequency domain to obtain the elastic information of the tissue. The experimental results show that the TS-FCI method has a velocity estimation error of 11 % and a contrast to noise ratio (CNR) of 3.81 when estimating inclusions with smaller dimensions (2.53 mm). Furthermore, when dealing with inclusions with small elastic changes (10 kPa), the velocity estimation error is 3 % and the CNR is 3.21. Compared to conventional time-domain and frequency-domain analysis methods, the proposed method has advantages. Results and analysis have shown that this method has potential promotional value in the quantitative evaluation of organizational elasticity.

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Abstract Objective To evaluate the effects of rosacea on ocular surface changes such as alterations in dry eye parameters, corneal densitometry, and aberrations, in comparison with healthy controls. Methods A total of 88 eyes of 44 patients diagnosed with rosacea and 88 eyes of 44 healthy controls were enrolled in this cross-sectional study. All participants underwent a comprehensive dermatologic and ophthalmic examination and Tear Break-Up Time (TBUT) and Schirmer-1 tests were performed. The rosacea subtype and Demodex count and OSDI scores of all participants were recorded. Corneal topographic, densitometric, and aberrometric measurements were obtained using the Scheimpflug imaging system. Results The mean age of the 44 patients was 41.2 ± 11.0 years of whom 31 (70.5%) were female. The mean TBUT and Schirmer-1 test values were significantly decreased and OSDI scores were significantly increased in the rosacea group compared to healthy controls (p < 0.01 for all). The most common subtype of rosacea was erythematotelangiectatic rosacea (70.4%). The severity grading of rosacea revealed that 18 (40.9%) patients had moderate erythema. The median (min-max) Demodex count was 14.0 (0-120) and the disease duration was 24.0 (5-360) months. The comparison of the corneal densitometry values revealed that the densitometry measurements in all concentric zones, especially in central and posterior zones were higher in rosacea patients. Corneal aberrometric values in the posterior surface were also lower in the rosacea group compared to healthy controls. The topographic anterior chamber values were significantly lower in the rosacea group. Study limitations Relatively small sample size, variable time interval to hospital admission, and lack of follow-up data are among the limitations of the study. Future studies with larger sample sizes may also enlighten the mechanisms of controversial anterior segment findings by evaluating rosacea patients who have uveitis and those who do not. Conclusion Given the fact that ocular signs may precede cutaneous disease, rosacea is frequently underrecognized by ophthalmologists. Therefore, a comprehensive examination of the ocular surface and assessment of the anterior segment is essential. The main priority of the ophthalmologist is to treat meibomian gland dysfunction and Demodex infection to prevent undesired ocular outcomes.

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AIM: To evaluate the trending visual performance of different intraocular lenses (IOLs) over time after implantation. METHODS: Ninety-one patients received cataract surgery with implantations of monofocal (Mon) IOLs, segmental refractive (SegRef) IOLs, diffractive (Dif) IOLs, and extended-depth-of-focus (EDoF) IOLs were included. The aberrations and optical quality collected with iTrace and OQAS within postoperative 6mo were followed and compared. RESULTS: Most of the visual parameters improved over the postoperative 6mo. The postoperative visual acuity (POVA) of the Mon IOL, SegRef IOL, and EDoF IOL groups achieved relative stability in earlier states compared with the Dif IOL group. Nevertheless, the overall visual performance of the 3 IOLs continued to upturn in small extents within the postoperative 6mo. The optical quality initially improved in the EDoF IOL group, then in the Mon IOL, SegRef IOL, and Dif IOL groups. POVA and objective visual performance of the Mon IOL and EDoF IOL groups, as well as POVA and visual quality of the Dif IOL group, improved in the postoperative 1mo and stabilized. Within the postoperative 6mo, gradual improvements were observed in the visual acuity and objective visual performance of the SegRef IOL group, as well as in the postoperative optical quality of the Dif IOL group. CONCLUSION: The visual performance is different among eyes implanted with different IOLs. The findings of the current study provide a potential reference for ophthalmologists to choose suitable IOLs for cataract patients in a personalized solution.

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Purpose: Any new intraocular lens (IOL) on the market claims to outperform competitors. We aimed to estimate the modulation transfer function (MTF) for different defocus of a novel refractive enhanced depth of focus (EDoF) IOL and the simulated visual acuity over this range of vision. Further, we analyzed the wavefront pattern produced by this IOL to reveal the function of the IOL's optics. Methods: For the novel TECNIS® PureSee® (ZEN00V) IOL, through frequency and through focus MTF were recorded on the optical bench (ISO-2 Cornea 0.28 µm, 546 nm). MTFa and the simulated visual acuity were calculated for different defocus. Apertures of 3 mm and 4.5 mm were applied. Higher order aberrations of the IOLs' optics were recorded and analyzed. Results: PureSee® IOL demonstrated a considerable depth of focus of about 1.7 D at the spectacle plane and a continuous simulated visual acuity over this range of defocus. For the 4.5 mm aperture, near focus depth was reduced, yet far distance MTF was even better. Higher order aberrations revealed increased primary and secondary spherical aberrations. Conclusion: Optical bench results suggest that the new ZEN00V matches the clinical criteria of an EDoF IOL by an increased range of vision and is far distance dominant for an enlarged pupil. This behaviour seems to be due to subtle power changes in the central optics that produce a complex modification of wavefront.

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In this work, we propose elastic metamaterials with phase discontinuities to steer the propagation of near-source bulk waves in a semi-infinite elastic medium. Our design exploits an array of embedded subwavelength resonators with tailored masses to attain a complete phase shift spanning [Formula: see text]. This phase control allows for diverse wave functionalities, such as directional refraction and energy focusing. Through the use of dispersion diagrams and the generalized Snell's law, along with a multiple scattering formulation, we analytically demonstrate the effectiveness of our design in achieving the desired wavefront manipulation. The proposed design has the potential to advance the field of guiding elastic waves using metamaterials and find practical applications in areas such as isolating ground-borne vibrations in densely urbanized regions and energy harvesting. This article is part of the theme issue 'Current developments in elastic and acoustic metamaterials science (Part 1)'.

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PURPOSE: The purpose of this study was to evaluate the in vivo efficacy of the estimations of wavefront analyzers using Hartmann-Shack technology to measure optical aberrations when the pupil size is smaller than the evaluated pupil area. METHODS: Patients implanted with the monofocal ZCB00 intraocular lens (Johnson and Johnson) were examined with the KR-1W Wavefront Analyzer (Topcon) without pharmacological mydriasis and with it afterward. Optical aberrations were analyzed considering a 4-mm pupil and a 6-mm pupil for both examinations. RESULTS: Sixty-six eyes of 33 patients with a mean axial length of 23.35 ± 0.91 mm were assessed. The mean pupil diameter at the baseline examination was 5.05 ± 0.88 mm and under pharmacological mydriasis, it was 6.29 ± 0.84 mm. Outcomes were similar with and without dilation in the 4-mm comparison. However, there was a great disparity in the 6-mm comparison. Most of the values obtained under mydriasis were statistically lower than at baseline (P < 0.05). CONCLUSION: The iris interferes with measurements of wavefront aberrations, and therefore, real pupil size should always be checked before evaluating optical aberrations with Hartman-Shack sensors. When pupil size is smaller than the analyzed diameter, ocular, and internal, and sometimes, corneal aberrations are estimated far more positive than real values.

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Achieving diffraction-limited performance in fourth-generation synchrotron radiation sources demands monochromator crystals that can preserve the wavefront across an unprecedented extensive range. There is an urgent need for techniques of absolute crystal diffraction wavefront measurement. At the Beijing Synchrotron Radiation Facility (BSRF), a novel edge scan wavefront metrology technique has been developed. This technique employs a double-edge tracking method, making diffraction-limited level absolute crystal diffraction wavefront measurement a reality. The results demonstrate an equivalent diffraction surface slope error below 70 nrad (corresponding to a wavefront phase error of 4.57% λ) r.m.s. within a nearly 6 mm range for a flat crystal in the crystal surface coordinate. The double-edge structure contributes to exceptional measurement precision for slope error reproducibility, achieving levels below 15 nrad (phase error reproducibility < λ/100) even at a first-generation synchrotron radiation source. Currently, the measurement termed double-edge scan (DES) has already been regarded as a critical feedback mechanism in the fabrication of next-generation crystals.

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In situ wavefront sensing plays a critical role in the delivery of high-quality beams for X-ray experiments. X-ray speckle-based techniques stand out among other in situ techniques for their easy experimental setup and various data acquisition modes. Although X-ray speckle-based techniques have been under development for more than a decade, there are still no user-friendly software packages for new researchers to begin with. Here, we present an open-source Python package, spexwavepy, for X-ray wavefront sensing using speckle-based techniques. This Python package covers a variety of X-ray speckle-based techniques, provides plenty of examples with real experimental data and offers detailed online documentation for users. We hope it can help new researchers learn and apply the speckle-based techniques for X-ray wavefront sensing to synchrotron radiation and X-ray free-electron laser beamlines.

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PURPOSE: To compare the clinical outcomes of myopiacorrected with corneal-wavefront-guided (CWG) laser in situ keratomileusis (LASIK) with AMARIS 1050S (SCHWIND eye-tech-solutions GmbH & Co. KG) and corneal-topography-guided (CTG) LASIK with WaveLight EX500 (Alcon Laboratories, Fort Worth, TX). METHODS: In this prospective, pseudo-randomized expanded cohort study, a total of 266 patients were subjected to binocular LASIK surgery, either with WaveLight EX500 (WaveLight group) or Amaris 1050S (AMARIS group) platforms. Data related to right eyes were selected for analysis. Corneal higher-order aberration (HOA) was selected as the primary endpoint; while visual acuity and refraction were the secondary endpoints. All the endpoints were assessed at 3 months postoperatively. RESULTS: There were 134 eyes in the AMARIS group and 132 eyes in the WaveLight group. After 3 months of postoperative follow-up, spherical and coma aberrations were significantly lower (P < 0.05) in the WaveLight group (spherical aberration: - 0.104 ± 0.199 µm; coma aberration: - 0.117 ± 0.202 µm) in comparison with the AMARIS group (spherical aberrations: 0.254 ± 0.146 µm; coma aberrations: 0.316 ± 0.297 µm). In the AMARIS group, 96.3% of the eyes achieved an uncorrected distance visual acuity (UDVA) of 20/20 while in the WaveLight group, 96.2% of the eyes achieved an UDVA of 20/20. Furthermore, the mean postoperative manifest refraction spherical equivalent (MRSE) was - 0.02 ± 0.28 in the AMARIS group and - 0.05 ± 0.21 in the WaveLight group (P = 0.34). CONCLUSIONS: Both WaveLight EX500 and Amaris 1050S LASIK showed excellent refractive and visual outcomes. In addition, the WaveLight group showed minimal spherical and coma aberrations when compared to the AMARIS group.

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Dielectric phase gradient metasurfaces have emerged as promising candidates to shrink bulky optical elements to subwavelength thickness scale based on dielectric meta-atoms. These meta-atoms strongly interact with light, thus offering excellent phase manipulation of incident light. However, to fulfill 2π phase control using meta-atoms, the metasurface thickness, to date, is limited to the order of 102 nm. Here, we present the thickness scaling down of phase gradient metasurfaces to <λ/20 by using excitonic van der Waals metasurfaces. High-refractive-index enabled by exciton resonances and symmetry-breaking nanostructures in the patterned layered tungsten disulfide (WS2) corporately enable quasibound states in the continuum in WS2 metasurfaces, which consequently yield complete phase regulation of 2π with the thickness down to 35 nm. To illustrate the concept, we have experimentally demonstrated beam steering, focusing, and holographic display using WS2 metasurfaces. We envision our results unveiling new venues for ultimate thin phase gradient metasurfaces.

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Purpose: To evaluate the changes of higher-order wavefront aberrations following the Smooth Incision Lenticular Keratomileusis (SILKTM) procedure for correction of myopic refractive errors with and without astigmatism, using the ELITATM Femtosecond Platform. Methods: This prospective study included 24 eyes that underwent SILK procedure using one ELITA femtosecond laser system for the correction of myopic refractive errors with and without astigmatism. Preoperative and postoperative 1-day, 1-week, 1-month, 3-month, and 9-month eye exams were measured with a commercial wavefront aberrometer (iDESIGN ® Refractive Studio, Johnson & Johnson Surgical Vision, Inc). Wavefront aberrations up to the 6th order Zernike coefficients, including coma Z(3, -1) and Z(3, 1), spherical aberration Z(4, 1), and the wavefront error of all higher-order aberrations (HOAs RMS), were evaluated across a 6 mm pupil. Results: The mean manifest refractive spherical equivalent changed from the preoperative refractions -3.82 ± 1.26 D (range -6.00 to -2.25 D) to the postoperative refractions -0.20 ± 0.15 D (range -0.50 to 0.00 D) at the 9-month follow-up. Compared to baseline preoperative HOAs, the mean postoperative HOAs were significantly increased at the 1-day follow-up. On average, at the 9-month postoperative assessment the vertical coma Z(3, -1) was -0.054 ±0.186 µm, horizontal coma Z(3, 1) was 0.016 ± 0.124 µm, spherical aberration Z(4, 0) was 0.046 ± 0.163 µm, and HOAs RMS was 0.363 ± 0.115 µm across a 6 mm pupil. There is no significant difference in the mean HOAs starting at 1-week follow-up for the horizontal coma (P = 0.346) and spherical aberration (P = 0.095). Conclusions: The visual outcomes demonstrated that the SILK procedure for refractive lenticule extraction using ELITA femtosecond laser system is effective and predictable for the correction of myopic refractive errors with and without astigmatism. The ELITA femtosecond laser system induced minimal HOAs in surgical eyes following the SILK procedures. These results demonstrate fast corneal recovery starting at 1-week follow-up, and spherical aberration was not induced.