Objective cataract grading methods and expected contrast sensitivity reestablishment with multifocal intraocular lenses

• Published in: International ophthalmology Vol. 43; no. 8; pp. 2825 - 2832
• Main Authors: Fernández, Joaquín, Burguera, Noemí, Rocha-de-Lossada, Carlos, Rachwani-Anil, Rahul, Rodríguez-Vallejo, Manuel
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2023; Springer Nature B.V
• Subjects: Acuity; Age; Cataract - diagnosis; Cataracts; Contrast Sensitivity; Humans; Implantation; Intraocular lenses; Lens Implantation, Intraocular - methods; Lenses, Intraocular; Medicine; Medicine & Public Health; Multifocal Intraocular Lenses; Ophthalmology; Original Paper; Phacoemulsification; Presbyopia; Prosthesis Design; Retrospective Studies; Sclerosis; Sensitivity; Surgery; Visual acuity; Screening; Defocus curves; Multifocal intraocular lens; Contrast sensitivity
• ISSN: 1573-2630; 0165-5701; 1573-2630
• DOI: 10.1007/s10792-023-02680-8

Purpose To determine the cut-off points for age and metrics provided by cataract grading objective systems for which a reestablishment in contrast sensitivity (CS) is expected after multifocal intraocular lens (MIOL) implantation. Methods One hundred seven subjects were included in this retrospective analysis carried out during the screening for presbyopia and cataract surgery. Monocular distance corrected contrast sensitivity defocus curve (CSDC) and visual acuity were measured, and crystalline lens sclerosis was graded with three objective metrics: Ocular Scatter Index (OSI), Dysfunctional Lens Index (DLI) and Pentacam Nucleus Staging (PNS). A CS value of 0.8 logCS at far distance, following published literature on this matter, was selected to compute the cut-off that maximized the detection of eyes exceeding this value at the preoperative screening, either for age or objective metrics. Results The CDCS showed a stronger correlation than CDVA with objective grading methods, whereas all objective metrics were significantly correlated between them ( p  < 0.05). The cut-offs for age, OSI, DLI and PNS were ≤ 62, ≤ 1.25, ≥ 7.67 and ≤ 1, respectively. The OSI provided the highest area under the receiver operating characteristic curve (0.85) followed by the age (0.84), DLI (0.74) and PNS (0.63). Conclusions Surgeons conducting clear lens exchange should communicate the possible distance CS loss after surgery with MIOL implantation according to the previous described cut-offs points. Age in combination with any cataract grading objective system is recommended to detect possible inconsistencies.