A novel approach for assessing visual impairment caused by intraocular lens opacification: high-resolution optical coherence tomography: Straylight prediction in locally opacified IOLs.

ABSTRACT Purpose : To quantify in vitro straylight induced by intraocular lens (IOL) localized opacification using an anterior segment OCT device. Design : Laboratory investigation. Methods : We obtained high-resolution optical coherence tomography (OCT) cross-section images of 44 explanted IOLs using a new in-vitro application for an anterior segment OCT device, the Anterion (Heidelberg Engineering, Heidelberg, Germany). In 24 cases, the reason for IOL explantation was a centrally localized opacification, the sequela of a secondary ocular surgery. As a control, we used 20 IOLs removed after an IOL (sub-)luxation. Using image analysis, we found a threshold area value representing a metric for the amount of opacification in a region of interest in the IOL's central optic. We used a modified C-Quant straylight meter (Oculus, Wetzlar, Germany) to quantify light scattering. We derived a linear regression from calculating the correlation between the amount of opacification and straylight. Results : We visualized different amounts of IOL opacification using the OCT device. The opacified lenses showed a mean threshold area of 6.7 ±3.3 % and mean straylight was 95.1 ±75.6 deg2/sr. The Clear group's mean threshold area was 2.0 ±0.8 % and 5.0 ±3.4 deg2/sr mean straylight. Straylight correlated statistically significant with the threshold area, with a correlation coefficient of R2=0.80, P Conclusions : This high-resolution OCT imaging technique can be used to visualize IOL pathologies. The amount of opacification correlated well with the straylight induced by the lens. AS-OCT imaging might be used in the future as a tool for predicting the extent of visual impairment and aid clinicians to quantify patients' complaints.