Quantitative Multiparameter Evaluation of Vacuoles in Intraocular Lenses Employing a High-Magnification Digital Microscopy Method.

Vincent Spiezio,Ilko K Ilev,Bennett N Walker,Don Calogero

doi:10.1155/2019/7929014

Abstract

As small imperfections with micrometric sizes, fluid-filled vacuoles, also referred to as glistenings, in intraocular lenses (IOLs) have been known to induce significant unwanted light scattering that in several cases presumably cause complaints and sometimes lead to IOL explantation and replacement. This unwanted scatter is of particular concern for patients viewing bright light in reduced-light conditions such as when driving at night, as the scattered light toward the retina can cause temporary blindness. In this study, we have developed and implemented an accurate test methodology based on a high-magnification digital microscopy approach for quantitative multiparameter evaluation and classification of IOL vacuoles depending on their critical optical characteristics including vacuole size, density, shape, and orientation within the IOL material. Using the multiparameter database developed by evaluating vacuole characteristics, we established a classification grading system that can be used to evaluate vacuole effects on light scattering.

Highlights

Intraocular lens (IOL) implantation to treat cataracts and aphakia is one of the most commonly performed surgical procedures, with about 3.6 million per year in the United States alone [1, 2]
We developed and implemented an accurate test methodology based on a high-magnification digital microscopy approach to quantitatively evaluate and classify IOL vacuoles depending on their critical multiparameter optical characteristics including vacuole size, density, shape, and orientation. is quantitative multiparameter evaluation method was used to establish a new classification grading system that can potentially be employed to evaluate vacuole effects on light scattering
To quantitatively evaluate multiparameter optical characteristics of light-scattering vacuoles in IOLs, we developed an experimental test methodology using a high-magnification digital microscopy approach illustrated in Figure 1(a). e test system includes a digital optical microscope (VHX-100, Keyence, Inc.) that provides some advanced features essential for this study such as high magnification in the range of 75x to 5000x, a large objective working distance of 3 mm to 48 mm, and a submicron spatial resolution for precisely measuring IOL vacuole size, density, shape, and orientation

Summary

Introduction

Intraocular lens (IOL) implantation to treat cataracts and aphakia is one of the most commonly performed surgical procedures, with about 3.6 million per year in the United States alone [1, 2]. Some newer designs and materials used in IOLs have an increased tendency to form small, micrometer-sized, fluid-filled vacuoles within the bulk of the IOL [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18]. Ese vacuoles, commonly referred to as glistenings, have been shown to reduce contrast sensitivity (CS) and visual acuity (VA) [13, 14, 17, 19,20,21], in some cases requiring IOL explantation [17, 21]. Straylight can cause disability glare, so further distinctions need to be made between the angular degree of scattered light and clinical effects

Objectives

Methods

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Discussion

Conclusion