June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Understanding visual complaints of two intraocular lens explant cases
Author Affiliations & Notes
  • Marrie Van der Mooren
    Applied Research, AMO Groningen BV, Groningen, Netherlands
  • Roger F Steinert
    Gavin Herbert Eye Institute,University of California, Irvine, CA
  • Farrell Tyson
    Cape Coral Eye center, Cape Coral, FL
  • Robert Rosen
    Applied Research, AMO Groningen BV, Groningen, Netherlands
  • Linda Lundstrom
    KTH Royal Institute of Technology, Stockholm, Sweden
  • Patricia A Piers
    Applied Research, AMO Groningen BV, Groningen, Netherlands
  • Footnotes
    Commercial Relationships Marrie Van der Mooren, AMO GRONINGEN BV (E); Roger Steinert, Abbott Medical Optics Inc (C); Farrell Tyson, Abbott Medical Optics Inc. (C); Robert Rosen, AMO Groningen BV (E); Linda Lundstrom, AMO GRONINGEN BV (F); Patricia Piers, AMO GRONINGEN BV (E)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1076. doi:
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      Marrie Van der Mooren, Roger F Steinert, Farrell Tyson, Robert Rosen, Linda Lundstrom, Patricia A Piers; Understanding visual complaints of two intraocular lens explant cases . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1076.

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      © ARVO (1962-2015); The Authors (2016-present)

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In two different cases, multifocal intraocular lenses (MFIOLs) were explanted due to visual complications related to the presence of micro-vacuoles in the optic body. These micro-vacuoles cause straylight, which resulted in complaints of hazy and blurry vision. The purpose of this study is to objectively measure and systematically quantify the visual impact of this straylight. The study will thereby give a better understanding of the origin of reported visual complaints when micro-vacuoles are present.


The amount of straylight in the two explanted MFIOLs was measured using an in-vitro setup and quantified using the scattering parameter s. To determine the impact of straylight on vision, photographic filters characterized in the same in-vitro setup were used to induce straylight on five subjects. Four different psychophysical visual tests were used: halo size, luminance detection with a glare source, and contrast sensitivity (CS) with and without the presence of glare. For all tests, the impact was modeled as a linear interpolation of the logarithm of the test score against the logarithm of the scattering parameter, log(s).


The straylight measured by the in-vitro setup was 6 deg2/sr for case 1 and 4 deg2/sr for case 2. Assuming a base straylight level of 1.1 log(s), the induced increase for the two patients was 0.17 log(s) and 0.12 log(s) respectively.<br /> The impact for the visual tests per unit of log(s) was the following: for halo size, 0.55 log(degrees)/log(s); for luminance detection 2.72 log(cd/m2)/log(s); for CS without glare, 0.33 log(CS)/log(s); and for CS with glare, 0.58 log(CS)/log(s). The induced straylight for the two explanted MFIOLs therefore corresponds to an increase of halo size of 24% and 16%, a luminance detection threshold increase of 190% and 112%, a contrast sensitivity decrease of 12% and 9% without a glare source, and a contrast sensitivity decrease of 20% and 9% with a glare source.


In the explanted MFIOLs we could objectively measure straylight. This straylight corresponds psychophysically to increases in halo size, loss of luminance sensitivity and decrease in contrast sensitivity. Among the visual tests, measurement of luminance detection showed the highest sensitivity.


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