Utility of the optical quality analysis system for decision-making in cataract surgery

Hwang, Jiyoung; Lee, Yoon Pyo; Bae, So Hyun; Kim, Ha Kyoung; Yi, Kayoung; Shin, Young Joo

doi:10.1186/s12886-018-0904-1

Cited by 20 publications

(16 citation statements)

References 37 publications

(67 reference statements)

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“…It is, therefore, more closely related to the OSI, given that it assesses one of the direct consequences of increased scattered light in the eye media [36]. Thus, the OSI provides a sensitive and specific method for diagnosing cataracts [37,38], proving to be the most effective optical quality parameter for use in decision-making in cataract surgery [39]. Moreover, it has been proposed as a way of validating a patient's visual complaints, providing an objective quantification of the visual degradation that actually affects tasks necessary to maintain a good quality of life, such as driving [37].…”

Section: Discussionmentioning

confidence: 99%

Intraocular scattering as a predictor of driving performance in older adults with cataracts

et al. 2020

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Cataracts can limit a person's ability to perform vision-dependent tasks safely, affecting the quality of life of older people. This study examines the relationship between visual function and driving, by studying which visual parameters might be important for predicting driving performance in older drivers with and without cataracts, ascertaining whether the objective measurement of intraocular scattering should be considered in assessment procedures for older drivers. This cross-sectional study involved a total of 20 older drivers (10 patients with bilateral cataracts and 10 control subjects). All participants were examined for visual acuity, contrast sensitivity, visual discrimination capacity, and intraocular scattering. Driving performance was also tested using a driving simulator. To study the relationship between visual parameters and driving performance, a correlation analysis and regression model were used. Drivers with cataracts showed a significantly impaired (p<0.05) visual function, with an Objective Scattering Index (OSI) 3.5 times greater than the control group. Driving performance was also significantly worse (p<0.05) in drivers with cataracts, reflected by a notable deterioration in lane keeping. The correlation analysis showed significant associations between driving performance and all the visual parameters studied. Finally, the regression model revealed that the OSI was the best predictor of driving performance, accounting for 51.3% of its variance. Visual function and driving performance are markedly deteriorated when cataracts are present. Our results demonstrate that the objective scattering index (OSI) has a high predictive power when it comes to simulated driving performance in older drivers, both with and without cataracts, suggesting that scatter measurements could be important in helping better understand visual limitations in older drivers.

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Section: Discussionmentioning

confidence: 99%

Intraocular scattering as a predictor of driving performance in older adults with cataracts

et al. 2020

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“…Optical quality after cataract surgery gained more and more attention for providing satisfactory visual outcomes [20,21]. Studies have shown that FLACS produce better clear corneal incision morphology [8], more precise reproducible capsulotomies [9][10][11][12][13], and better IOL centration [11] when compared with conventional PCS.…”

Section: Discussionmentioning

confidence: 99%

Comparison of optical quality and distinct macular thickness in femtosecond laser-assisted versus phacoemulsification cataract surgery

et al. 2020

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Background: Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery (FLACS). In current research, we evaluated optical quality recovery and distinct macular thickness changes after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation,1 week and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI (p < 0.0001), PSF (strehl ratio, SR) (p = 0.027) and MTF (p = 0.028), but not intraocular pressure (IOP) (p = 0.857). The differences between pre-operation and post-operation for DLI (p = 0.031), SR (p = 0.01) and IOP (p = 0.03), but not MTF (p = 0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 (p = 0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group at 1 month. In PCS group, we found the differences between pre-operation and postoperation in nasal inter macular ring thickness (NIMRT) (p = 0.03), foveal volume (FV) (p = 0.034) and average retinal thickness (ART) (p = 0.025) but not FLACS group at 1 month. Conclusion: FLACS is safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast, PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.

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“…Our population sample was representative of general French population who undergo cataract surgery [4]. Even if BCVA may be less considered now, as the latest recommendations not include it in surgery decision-making, our mean BCVA respected the previous cutoff established by the competent Health Authorities, like Hwang et al [53], or contrary to some studies evaluating the OQAS on patients with lower preoperative logMAR BCVA at earlier stages agerelated cataract [21,49,50,[54][55][56].…”

Section: Discussionmentioning

confidence: 81%

“…Previous studies on the OQAS showed no consensus on population selection: most authors chose to include cataracts with different components (N/C/P) [49,50,53,55,56,59], but one selected only nuclear cataracts [21]. As cortical components cause disability in daily life without necessarily greatly impairing visual acuity [57,62], we chose to consider every type of cataract (N/C/P) for both population selection and LOCS III grading, to prevent potential bias: Artal et al [40] did not consider this point in selecting their population, and mentioned it as a limitation.…”

Section: Plos Onementioning

confidence: 99%

Using Optical Quality Analysis System for predicting surgical parameters in age-related cataract patients

et al. 2020

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The Optical Quality Analysis System (OQAS, Visiometrics) provides objective measurements of image formed onto retina, by combining quantification of ocular media transparency and of optical aberrations. In order to evaluate its contribution in the assessment of age-related cataract, we conducted a monocentric clinical study to determine the relationships between clinical grading of lens opacity, OQAS parameters, and parameters required for cataract surgery by phacoemulsification with ultrasound (called "phacodynamics"). Clinical parameters were: best-corrected visual acuity (BCVA, expressed as Log of minimal angle resolution (logMAR)) and the lens opacity classification system III (LOCS III) as a gold standard determined by two independent observers who graded total cataract and nuclear, cortical and posterior sub capsular components. The OQAS provided an objective scatter index (OSI), a modulation transfer function (MTF, expressed in cycle per degree (cpd)) and a Strehl ratio (SR) used as an aberration marker. Patients were operated on by the same surgeon using a phacoemulsification machine that provided the cumulative dissipated energy (CDE) and total ultrasound time (US time) necessary to extract the lens. Patients with poor compliance, corneal or retinal diseases impairing OSI, or who required surgical settings variation, were excluded. Twenty-one eyes of 21 patients aged 76±8 years were analyzed. They were 11 pure nuclear, 3 pure cortical, and 7 mixed cataracts. Mean LOCS III and OSI were respectively: 4.86 ±2.03 and 6.12 ±3.07 (mean±SD). Medians (10˚-90˚percentiles) were: for BCVA 0.30 (0.10-0.70) logMAR, for MTF cutoff 9.31 (1.54-30.57) cpd, for SR 0.071 (0.042-0.146), for CDE 8.04 (5.74-23.29) and for US time 58 (39-116) seconds. LOCS III was significantly correlated (spearman r, r s) with BCVA (r s = 0.561, p = 0.008), CDE (r s = 0.457, p = 0.038) and US time (r s = 0.647, p = 0.002). The three OQAS parameters significantly correlated (all r s � 0.526, p<0.05) with BCVA, and LOCS III grading, but the strongest correlations were found with OSI for cortical components and with MTF for nuclear components: only OSI may be used objectively to assess the effect of cortical components on optical quality, and MTF cutoff-integrating scattering and aberrationsseems the best objective parameter for clinical assessment of nuclear cataracts. The three OQAS parameters were also significantly correlated (r s) with CDE, and with US time only for

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Utility of the optical quality analysis system for decision-making in cataract surgery

Cited by 20 publications

References 37 publications

Intraocular scattering as a predictor of driving performance in older adults with cataracts

Intraocular scattering as a predictor of driving performance in older adults with cataracts

Comparison of optical quality and distinct macular thickness in femtosecond laser-assisted versus phacoemulsification cataract surgery

Using Optical Quality Analysis System for predicting surgical parameters in age-related cataract patients

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