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Assessment of straylight and the modulation transfer function of intraocular lenses with centrally localized opacification associated with the intraocular injection of gas

Publication year 2018
Published in Journal of Cataract and Refractive Surgery
Authors Grzegorz Łabuz, Timur M Yildirim, T.J.T.P. van den Berg, Ramin Khoramnia, Gerd U Auffarth

PURPOSE: To assess the optical quality of intraocular lenses (IOLs) explanted because of opacification after the intraocular injection of gas.

SETTING: David J. Apple Laboratory, Heidelberg, Germany.

DESIGN: Experimental study.

METHODS: Four hydrophilic acrylic IOLs were studied, each with a centrally localized round opacification pattern associated with the intraocular use of gas. Laboratory analysis included gross examination with a light microscope, followed by alizarin and von Kossa staining. Optical quality was assessed by examining the modulation transfer function (MTF) and straylight. Results were compared with those of a control IOL and normative data for straylight of the crystalline lens. The following parameters were derived from image analysis: opacified surface fraction, light loss in the opacified surface, and the area and number of granules. The relationship between straylight increase and those parameters was studied.

RESULTS: Fine granules were identified on the IOL surface and subsurface. The granules stained positive for calcium, and the MTF levels of 2 IOLs dropped markedly. The other 2 showed relatively minor changes. The straylight was extremely increased in 3 IOLs up to (and above) a level of that of a cataractous lens. A proportional relationship was found between straylight and the morphological parameters from image analysis.

CONCLUSIONS: Intraocular lenses with centrally localized opacification have a strong potential for deteriorating optical performance. However, the optical quality might differ depending on the morphology of opacification. A serious straylight increase was found in most of these IOLs, suggesting that affected patients may suffer from glare-related symptoms.

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