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P. P. Marvan, C. Nischler, C. Hufnagl, M. Emesz, G. Grabner; Intraocular Straylight After Cataract Surgery and in a Large Control Group. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4460. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To measure intraocular straylight in patients with pseudophakia and to compare the results with those in a large population sample either without eye diseases and with different signs of incipient senile cataract.
In a large prospective European study with five participating eye clinics (in Germany, Spain, Belgium, Holland and Austria) a total of 2211 active drivers, 45 years of age and older, were included. The examination included a complete ophthalmological evaluation with multiple visual function tests and the measurement of intraocular straylight with a newly developed system. Lens opacities were classified with the LOCS III lens classification system in a standardized way.
Increasing density of lens opacification (prior to cataract surgery) was significantly related to increased straylight values. This resulted in a modified behavior regarding the patients driving habits.Unexpectedly, patients with bilateral pseudophakia showed similar straylight values as those that were classified as having bilateral moderate cataract. Mean age of the pseudophakic patient group was similar to subjects with more severe forms of cataract.
Following cataract surgery and implantation of a clear artificial lens, one would expect intraocular straylight to be significantly lower that in the control population with moderate cataract. This was clearly not the case in this large series of patients, however.Several causes may be considered causative for this observation:First pseudophakia-related changes, such as untreated posterior capsular fibrosis and, possibly IOL decentration, have to be considered.Secondly increasing straylight values with age that are not only lenticular of origin, but also a consequence of age-related pigmentary changes such as migration and thinning of uveal pigment from the iris, increasing vitreal opacities and loss of melanin within the retinal pigment epithelium itself.This study demonstrates that the measurement of intraocular straylight is a very valuable additional parameter in the detailed assessment of ocular function.
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