Tear Film Hyperosmolarity is Associated with Increased Variation of Light Scatter Following Cataract Surgery.

Purpose: To study the association between tear film hyperosmolarity and ocular light scatter in a cataract surgery population. Patients and Methods: Contiguous, 20-second objective scatter index (OSI) scans were recorded in hyperosmolar (≥320 mOsm/L) and normal subjects (<308 mOsm/L) with cataract nuclear opacity ≥3. OSI was measured at screening, baseline and 90 days following surgery. Along with symptoms of ocular surface disease, slit-lamp examination included corneal staining (0-3), tear film breakup time (TBUT) and evaluation of meibomian gland disease (MGD). An additional cohort of hyperosmolar subjects were measured for OSI at screening, baseline, and 5, 10, 15 and 30 minutes following instillation of 0.18% sodium hyaluronate (HA). Results: Thirty-one eyes of 31 patients were included. There was a significant difference in post-operative OSI variation when comparing hyperosmolar (0.65±0.30, N=11) to normal subjects (0.33±0.11, N=10, p=0.005). Of note, there were no significant differences in OSI variation when subjects were sorted by staining (p=0.9), TBUT (p=0.7), symptoms (p=0.7), or MGD status (p=0.9). Instillation of 0.18% HA (N=10) did not alter OSI at 5 minutes, but significant reductions in OSI of 28.8%, 38.5% and 36.7% (all p < 0.001) were observed at 10, 15 and 30 minutes. Conclusion: Hyperosmolar patients exhibited significantly increased variation in light scatter following cataract surgery that was undifferentiated by staining or TBUT. Elevated osmolarity may be indicative of light scatter equivalent to that of a grade 2-3 cataract.

Visual Performance at All Distances and Patient Satisfaction With a New Aspheric Inverted Meniscus Intraocular Lens.

PURPOSE: To evaluate visual performance, spectacle independence, and quality of vision of new intraocular lenses (IOLs) for presbyopia correction with an aspheric inverted meniscus optical design (ArtIOLs; Voptica SL) in patients undergoing bilateral cataract surgery. METHODS: In this prospective study, 60 eyes from 30 patients implanted bilaterally with Art40 and Art70 IOLs were included. These new IOLs were designed with an inverted meniscus shape to improve the peripheral performance and with aspheric surfaces to induce different amounts of negative spherical aberration in each IOL model. Distance-corrected and uncorrected through-focus visual acuities and contrast sensitivity were measured 1 to 3 months after surgery. Twenty-eight patients answered Patient Reported Spectacle Independence (PRSIQ) and Quality of Vision (QoV) questionnaires. RESULTS: Mean monocular (Art40 and Art70) and binocular (Art40/70) corrected distance visual acuities (CDVA) were zero logMAR (20/20). Binocular uncorrected distance visual acuity (UDVA) at far, intermediate (66 cm), and near (40 cm) distances was 0.00 ± 0.01, 0.01 ± 0.03, and 0.09 ± 0.09 logMAR, respectively. Spectacle independence was achieved by 24 (85.7%) patients for far and intermediate vision and 20 patients (71.4%) for near vision. The number of patients never reporting experiencing glare, halos, and starbursts was 28, 27, and 26 (100%, 96.4%, and 92.9%), respectively. CONCLUSIONS: The binocular combination of two ArtIOLs models (Art40 and Art70) significantly extended the depth of focus up to at least 40 cm. This combination resulted in a full range of vision with a high level of spectacle independence and without the compromise of halos or dysphotopsias. [J Refract Surg. 2023;39(9):582-588.].

Optical memory effect of excised cataractous human crystalline lenses.

Cataracts increase the amount of scattered light in the crystalline lens producing low-contrast retinal images and causing vision impairment. The Optical Memory Effect is a wave correlation of coherent fields, which can enable imaging through scattering media. In this work, we characterize the scattering properties of excised human crystalline lenses by measuring their optical memory effect and other objective scattering parameters, finding the relationship between them. This work has the potential to help fundus imaging techniques through cataracts as well as the non-invasive correction of vision through cataracts.

Extended depth of focus with induced spherical aberration in light-adjustable intraocular lenses.

PURPOSE: To evaluate the quality of vision and depth of focus induced by controlled amounts of negative spherical aberration in patients implanted bilaterally with light-adjustable intraocular lenses. DESIGN: Prospective, nonrandomized clinical trial. METHODS: Seventeen patients were implanted and treated with appropriate spatial irradiance light profiles. One eye was set for emmetropia, and the fellow eye received an additional aspheric light treatment to induce controlled amounts of negative spherical aberration. We used a Hartmann-Shack sensor to measure the eye's refraction and aberrations for a 4-mm pupil diameter. Decimal visual acuity (VA) was measured using a micro-display placed at 10 m, 60 cm, 40 cm, and 30 cm. RESULTS: Eyes treated with aspheric profiles were divided into 2 groups depending on the final amount of induced negative spherical aberration: low [-0.05, -0.10 µm] and high [-0.13, -0.23 µm]. In both groups, the mean uncorrected decimal VA at 60 cm was over 0.90. In the first group, distance VA was 0.97 ± 0.16, but in the second group it was lower (0.76 ± 0.16). As expected, the VA for nearer distances is higher in the eyes with a larger magnitude of spherical aberration (P value < .01): 0.94 ± 0.10 and 0.73 ± 0.16 at 40 and 30 cm, respectively, in comparison with 0.71 ± 0.15 and 0.50 ± 0.14. Binocular summation with the fellow eye, adjusted for emmetropia, produces an excellent binocular distance VA (>1.10) in both groups. CONCLUSIONS: Controlled amounts of negative spherical aberration and defocus can be induced in eyes implanted with adjustable intraocular lenses to enhance near vision.