Visualization of Forward Light Scatter in Opacified Intraocular Lenses and Straylight Assessment.

Hyeck-Soo Son,Ramin Khoramnia,Michael C Knorz,Timur M Yildirim,Gerd U Auffarth,Grzegorz Łabuz,Chul Young Choi

doi:10.3390/diagnostics11081512

Abstract

Background: Qualitative visualization of forward light scatter and quantitative straylight measurement of intraocular lenses (IOLs). Methods: We analyzed two calcified IOL-explants, the Euromaxx ALI313Y (Argonoptics GmbH) and the LS-312 MF30 (Oculentis BV), one IOL with artificially induced glistenings (PC-60AD, Hoya), and one control (CT Asphina 409MP, Carl Zeiss Meditec AG) free of any opacification. Analysis included light microscopy, qualitative light scatter visualization using ray propagation imaging technique, and quantitative straylight measurement using C-Quant (Oculus). Results: More light scattering effect—visible as increased light intensity outside the IOL’s main focus—was evident in all opacified IOLs than the control. The highest straylight levels were observed in the Euromaxx (289.71 deg2/sr), which showed extensive granular deposits throughout its optic, followed by the MF30 (78.58 deg2/sr), which only showed opacification in its center. The glistenings-IOL demonstrated numerous microvacuoles within the optic and had straylight levels of 22.6 deg2/sr, while the control showed the lowest straylight levels (1.7 deg2/sr). Conclusions: Ray propagation imaging technique allowed qualitative assessment of off-axis veils of light that result from increased forward light scattering. Straylight was increased in all opacified lenses compared to the clear control lens. The IOL opacifications are significant sources of glare.

Highlights

Intraocular lens (IOL) opacification is a rare but serious complication that can severely degrade quality of vision and even require an intraocular lenses (IOLs) explantation [1,2,3,4,5,6,7,8,9,10,11,12,13]
While the IOL manufacturers set out to improve and develop new materials to avoid these complications, the clinician continues to be confronted with pseudophakic patients who complain of visual impairment, and ocular examination reveals that they have an opacified, older IOL model
While a similar pattern and density could be observed in the LS-312 MF30 (Figure 2J), the calcification was limited to the central area of the optic (Figure 2B,F)

Summary

Introduction

Intraocular lens (IOL) opacification is a rare but serious complication that can severely degrade quality of vision and even require an IOL explantation [1,2,3,4,5,6,7,8,9,10,11,12,13]. Regardless of the opacification type, there are many reports showing that both calcification and glistenings may lead to a reduction in light transmission, loss of contrast sensitivity, and an increase in light scattering, deteriorating the patients’ quality of vision and life [4,14,15,19]. Qualitative visualization of forward light scatter and quantitative straylight measurement of intraocular lenses (IOLs). Qualitative light scatter visualization using ray propagation imaging technique, and quantitative straylight measurement using C-Quant (Oculus). The glistenings-IOL demonstrated numerous microvacuoles within the optic and had straylight levels of

Methods

Results

Conclusion