A Novel Approach for Assessing Visual Impairment Caused by Intraocular Lens Opacification: High-Resolution Optical Coherence Tomography

PURPOSE: To quantify in vitro straylight induced by intraocular lens (IOL) localized opacification using an anterior segment optical coherence tomography (OCT) de-vice. DESIGN: Laboratory investigation. METHODS: We obtained high-resolution OCT cross-section images of 44 explanted IOLs using a new in vitro application for an anterior segment OCT device, the Anterion (Heidelberg Engineering, Heidelberg, Germany). In 24 cases, the reason for IOL explantation was a centrally localized opacification, the sequela of a secondary ocular surgery. As a control, we used 20 IOLs removed after an IOL (sub-)luxation. Using image analysis, we found a threshold area value representing a metric for the amount of opacification in a region of interest in the IOL's central optic. We used a modified C-Quant stray-light meter (Oculus, Wetzlar, Germany) to quantify light scattering. We derived a linear regression from calculating the correlation between the amount of opacification and straylight. RESULTS: We visualized different amounts of IOL opacification using the OCT device. The opacified lenses showed a mean threshold area of 6.7% +/- 3.3% and mean straylight was 95.1 +/- 75.6 deg(2)/sr. The clear group's mean threshold area was 2.0% +/- 0.8% and 5.0 +/- 3.4 deg(2)/sr mean straylight. Straylight correlated statistically significantly with the threshold area, with a correlation coefficient of R-2 = 0.80, P < .001. CONCLUSIONS: This high-resolution OCT imaging technique can be used to visualize IOL opacities. The amount of opacification correlated well with the stray-light induced by the lens. Anterior segment OCT imaging might be used in the future as a tool for predicting the extent of visual impairment and aid clinicians to quantify patients' complaints. (c) 2021 Elsevier Inc. All rights reserved.

Automated summary

The study focused on quantifying in vitro straylight induced by localized opacification in intraocular lenses (IOLs) using anterior segment optical coherence tomography (OCT). It found a significant correlation between the amount of opacification and straylight, demonstrating the potential of OCT imaging in predicting the extent of visual impairment caused by IOL opacities.