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

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. Methods: 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. Results: 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. Conclusions: 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.

<p>Objective Quantification of Image Quality and Optical Scatter Before and After Nd:YAG Capsulotomy Using a Double-Pass Technique</p>

“…For all eyes, regardless of morphology, there was a positive correlation (0.67, p<0.001) of OSI decrease with improvement in CDVA that was similar to our study. McMillin et al 40 retrospectively compared subjective grading to double-pass retinal imaging, measuring a mean decrease in OSI following YAG capsulotomy of 2.84 ± 0.76 (n=26, p=0.001), greater than the mean improvement in our study as they only had a few (n=4) eyes with low (1+) grading. In their series, patients with good initial BCVA (0.10 logMAR or better, n=10) but with symptoms of glare and halos also showed significant improvement in OSI (−0.76 ± 0.16, p=0.001) after capsulotomy, whereas the change in BCVA (−0.02 ± 0.02, p=0.34) was not significant.…”