Objective evaluation of vision quality in pseudophakic patients with posterior capsular opacification using double-pass retinal imaging.

Jake C Mcmillin,Karolinne M Rocha,George O Waring Iv,Eliza L Barnwell,Jorge S Haddad

doi:10.5935/0004-2749.20190039

Abstract

The purpose of this study was to objectively assess the optical vision quality of patients before and after Nd:YAG capsulotomy for posterior capsular opacification using a double-pass retinal imaging system. We retrospectively analyzed the data from 26 pseudophakic eyes with posterior capsular opacification that underwent Nd:YAG capsulotomy. The objective scatter indices, modulation transfer function cutoff frequencies, Strehl ratios, and logMAR corrected distance visual acuities were assessed before and after YAG capsulotomy with a double-pass retinal imaging system (OQAS II, Visiometrics, Spain). We also analyzed data from a subgroup of 10 patients with pre-YAG corrected distance visual acuity of 0.10 logMAR (20/25) or better. Vision quality indices improved in all 26 eyes, resulting in a statistically significant improvement in the corrected distance visual acuity (p=0.007), objective scatter index (p=0.001), modulation transfer function cutoff frequency (p=0.001), and Strehl ratio (p=0.020). The overall mean improvements included 0.12 ± 0.04 logMAR for corrected distance visual acuity, 2.84 ± 0.76 for objective scatter index, 12.29 ± 2.77 for modulation transfer function cutoff frequency, and 0.06 ± 0.03 for Strehl ratio. Our sub-analysis of 10 eyes with 0.10 logMAR (20/25) corrected distance visual acuity or better also showed a statistically significant improvement in the mean objective scatter index (0.76 ± 16; p=0.001), resulting in approximately 35% decrease in intraocular light scatter. The objective vision quality measurements as assessed by the double-pass retinal imaging system showed a significant improvement after YAG capsulotomy. This suggests that the objective scatter index improves after YAG capsulotomy, even in eyes with pre-YAG 0.10 logMAR (Snellen 20/25) corrected distance visual acuity or better.

Highlights

Posterior capsular opacification (PCO) is the most common late complication of cataract surgery associated with implantation of posterior chamber intraocular lenses (PCIOLs)(1)
We observed statistically significant improvements in all vision quality indices according to the paired student t-test
The corrected distance VA (CDVA) improved by a mean of 0.12 ± 0.04 (p=0.007), the objective scatter index (OSI) had a mean decrease of 2.84 ± 0.76 (p=0.001), the modulation transfer function cutoff frequency (MTF) cutoff frequency increased by 12.29 ± 2.77 (p

Summary

Introduction

Posterior capsular opacification (PCO) is the most common late complication of cataract surgery associated with implantation of posterior chamber intraocular lenses (PCIOLs)(1). More than a quarter of patients develop visually significant PCOs within 5 years of cataract surgery[1]. The underlying pathophysiological PCO mechanism stems from the intrinsic potential of retained lenticular epithelial cells to migrate and proliferate over the posterior capsule and into the visual axis[2]. The growth of these cells in the visual axis may cause decreased contrast sensitivity, visual acuity (VA), and worsening glare[3,4]. Forward light scatter has been proposed as a mechanism to evaluate visual function in patients with visually significant PCO[7]. Forward light scatter detects the light that does not come into focus on the retina because of aberrations within the optical system, resulting in halos, glares, and difficulty during driving under scotopic conditions[8]

Objectives

Methods

Results