Dynamic tracking of Purkinje images for the comparison of pseudophakodonesis between in-the-bag and secondary fixated intraocular lenses

Abstract

To compare the pseudophakodonesis of in-the-bag intraocular lens (IOL) and a secondary fixated IOL by tracking the Purkinje image IV. Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. Prospective case series. The IOL movement was recorded via slitlamp videography (DC3), streamed in video editor (Pinnacle), and evaluated by ImageJ analysis. The positional difference of Purkinje IV in relation to the stationary image Purkinje I at 3 random timeframes was measured. Pseudophakodonesis was quantified, compared, and correlated clinically. The study comprised 127 eyes that had posterior chamberIOLs (PC IOLs) (n=50), anterior chamber IOLs (AC IOLs) (n=20), iris-claw IOLs (n=20), glued IOLs (n=30), and sutured scleral-fixated IOLs (n=7). The iris-claw IOLshowed significant difference in Purkinje IV at various timeframes (P=.0418) whereas others showed no significant change. On comparison of the Purkinje IV difference, there was a significant difference between the PC IOL and the iris-claw IOL (P=.0001), the glued IOL and the iris-claw IOL (P=.0020), and the AC IOL and the iris-claw IOL (P=.0302). The iris-claw IOL showed significant exaggeration of the position of Purkinje IV (P=.0395) after saccade. Pseudophakodonesis seemed mild (difference<0.5mm) in the PC IOL (68%), glued IOL (53.3%), and AC IOL (50%); moderate in the scleral-fixated IOL (71.4%); and severe (≥ 1.0mm) in the iris-claw IOL (55%). Positional difference in Purkinje IV was highest in iris-claw IOLs and lowest in PC IOLs.