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M. Blundell, E. J. Mayer, N. Knox Cartwright, L. Hunt, D. Tole, A. D. Dick; The Effect of Hydroview Intraocular Lens Opacification on Visual Function: A Prospective Observational Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3761.
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© ARVO (1962-2015); The Authors (2016-present)
Hydroview (Bausch and Lomb) intraocular lenses (IOLs) have been associated with symptomatic opacification of the optic necessitating IOL exchange. Glare and misty vision have been noted as the most common presenting symptoms. This study investigates the impact of IOL opacification on vision related quality of life and objective measurements of visual function, including glare.
All patients that had Hydroview IOL implantation at Bristol Eye Hospital between December 2000 and the end of February 2001, a period of high risk for delayed opacification as defined by a prior local audit, were invited for assessment. Patients who were found to have Hydroview IOL opacification in routine ophthalmic clinics at the Bristol Eye Hospital were also invited for assessment. Vision related quality of life was measured by the Vision Core Module 1 (VCM-1) questionnaire, subject’s symptoms were also determined by questionnaire. Vision was assessed in the following modalities: glare; visual acuity; contrast sensitivity; visual field and colour vision. IOL opacification was assessed by dilated slit lamp biomicroscopy and using Scheimpflug image capture as well standard anterior segment photographs.
Data from 129 patients were analyzed. 50 subjects had opacified IOLs compared to 79 with clear IOLs. Subjects with opacified IOLs had greater frequency of symptoms for: blurred vision (P<0.001), misty vision (P<0.001), dazzled by bright lights (P=0.004), star shapes around lights (P=0.019), haloes around lights (P=0.009) and colours seeming dull (P<0.001). Subjects with opacified IOLs described their eyesight overall as worse than those with clear IOLs (P<0.001). Subjects with opacified IOLs demonstrated poorer LogMar vision (P=0.005), contrast sensitivity (P<0.001), visual field (<0.001) and glare (P<0.001). Opacification was also associated with worse VCM1 scores (P<0.001) indicating a lower visual related quality of life.
This study highlights the significant impact IOL opacification has on quality of life, patient symptoms and visual function. The results of which may have influence in decision making for IOL exchange as well as decision making for cataract extraction generally.
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