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Monica Camparini, Claudio Macaluso, Luca Reggiani, Giovanni Maraini; Retroillumination versus Reflected-Light Images in the Photographic Assessment of Posterior Capsule Opacification. Invest. Ophthalmol. Vis. Sci. 2000;41(10):3074-3079.
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purpose. To investigate the relative merit of retroillumination and of reflected
light slit-lamp–derived photographs in the assessment of the
opacification of the posterior lens capsule.
methods. Retroillumination and slit-lamp–derived reflected-light photographs
were taken on 23 consecutive eyes with posterior capsule opacification
(PCO) in uncomplicated pseudophakia. Subjective grading was performed
on both types of photographs to evaluate the extent and density of
posterior capsular opacification. Best-corrected visual acuity (BCVA)
before and after YAG laser capsulotomy was used to assess the impact of
capsular opacification on visual function.
results. After capsulotomy all patients attained a BCVA ≥ 46 letters
(≥20/32) with a mean increase of 25 letters, indicating that PCO was
the cause of visual impairment in these patients. The relative capacity
of retroillumination and of reflected-light photographs to adequately
capture the extent and the severity of posterior capsule opacification
varied considerably. Reflected-light images, in addition to frequently
producing higher severity scores for the opacity than retroillumination
photographs, in 4 of 23 eyes (17.4%) proved to be the only technique
able to document the presence of PCO.
conclusions. Our results indicate that, with respect to retroillumination images,
reflected-light photography has an increased ability to adequately
capture the presence and the severity of PCO and that the use of only
retroillumination images may lead to its underestimation. This may be
relevant to clinical studies aiming to evaluate incidence and
progression of this condition.
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