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

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Abstract

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.

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Acknowledgments

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain

    Joaquín Fernández, Noemí Burguera, Carlos Rocha-de-Lossada & Manuel Rodríguez-Vallejo

  2. Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N., 29009, Málaga, Spain

    Carlos Rocha-de-Lossada

  3. Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, S/N, 41009, Sevilla, Spain

    Carlos Rocha-de-Lossada

  4. Hospital Norte de Málaga, Avenida Poeta Muñoz Rojas, s/n, Málaga, 29200, Antequera, Spain

    Rahul Rachwani-Anil

Authors
  1. Joaquín Fernández
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  2. Noemí Burguera
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  3. Carlos Rocha-de-Lossada
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  4. Rahul Rachwani-Anil
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  5. Manuel Rodríguez-Vallejo
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Contributions

Conceptualization was contributed by JF, MR-V, CR and NB; methodology was contributed by JF, MR-V, CR and NB; software was contributed by MR-V; formal analysis was contributed by JF, MR-V and NB; resources were contributed by JF; data curation was contributed by MR-V, RR and NB; writing—original draft preparation, was contributed by MR-V and JF; writing—review and editing, was contributed by RR, NB and CR; supervision was contributed by JF; project administration was contributed by JF; funding acquisition was contributed by JF. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Manuel Rodríguez-Vallejo.

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Conflict of interest

The Multifocal Lens Analyzer was designed, programmed and it is distributed by the Research and Evidence Department of Qvision ahead by Dr. Fernández.

Ethical approval

This study was approved by the Ethics Committee of Research, Almería Center, Torrecárdenas Hospital Complex, and conducted in adherence with the tenets of the Declaration of Helsinki. For this type of study formal consent is not required.

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Fernández, J., Burguera, N., Rocha-de-Lossada, C. et al. Objective cataract grading methods and expected contrast sensitivity reestablishment with multifocal intraocular lenses. Int Ophthalmol 43, 2825–2832 (2023). https://doi.org/10.1007/s10792-023-02680-8

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  • DOI: https://doi.org/10.1007/s10792-023-02680-8

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