Objective classification of glistenings in implanted intraocular lenses using Scheimpflug tomography

Abstract

To evaluate whether ocular Scheimpflug tomography allows automated detection of glistenings in implanted intraocular lenses. Department of Ophthalmology, Goethe University, Frankfurt, Germany. Prospective, nonrandomized case series. Patients who had phacoemulsification with implantation of various types of monofocal intra-ocular lenses (IOL) were examined under mydriasis for glistenings with the following 3 methods: subjective quantification with a rating scale during slitlamp examination, manual counting in slitlamp photographs, and using a purpose-written digital-image processing program for automatic counting of glistenings in Scheimpflug images. Examinations were performed by the same examiner at least 6 months after IOL implantation. Methods were tested for consistency with the Cohen κ coefficient and single-factor analysis of variance. The subjectively graded glistenings (n = 63 patients, 63 eyes) during slitlamp examination showed the same glistening grade as the manually counted glistenings in slitlamp photographs, with a moderate agreement (κ = 0.46). The glistening count derived from Scheimpflug images was not associated with the glistening grades determined through any of the slitlamp methods (P > .05). Subjective glistening grading score showed a moderate agreement with counted score in slitlamp images. The Scheimpflug device used in this study did not provide images of required resolution to perform an automated counting of separate glistenings and thus classification. Drs. Biwer, Schmitt, Honig, Spratte, and Baumeister have no financial or proprietory interest in any material or method mentioned. Dr. Kohnen has received travel reimbursement and lecture fees and is a consultant to Abbott, Alcon, Thieme Compliance, Hoya, Rayner, Oculus, Schwind, and Zeiss.