Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study

Limei Zhang; Runhan Shi; Xuanzhu Chen; Xuefen Gu; Jiying Shen; Aijun Wang; Shuang Ni; Lei Cai; Haike Guo; Jin Yang

Advances in Ophthalmology Practice and Research (May 2025)

Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study

Limei Zhang,
Runhan Shi,
Xuanzhu Chen,
Xuefen Gu,
Jiying Shen,
Aijun Wang,
Shuang Ni,
Lei Cai,
Haike Guo,
Jin Yang

Affiliations

Limei Zhang: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Runhan Shi: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China; Key National Health Committee Laboratory of Myopia, Fudan University, And Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Xuanzhu Chen: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Xuefen Gu: Department of Ophthalmology, Shanghai Xinshijie Eye Hospital, Shanghai, China
Jiying Shen: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Aijun Wang: Department of Ophthalmology, Shanghai Bright Eye Hospital, Shanghai, China
Shuang Ni: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
Lei Cai: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China; Key National Health Committee Laboratory of Myopia, Fudan University, And Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
Haike Guo: Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China; Corresponding author. 83 Fenyang Road, Xuhui Direct, Shanghai, China.
Jin Yang: Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China; Key National Health Committee Laboratory of Myopia, Fudan University, And Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China; Corresponding author. Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.

Journal volume & issue: Vol. 5, no. 2
pp. 117 – 123

Abstract

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Purpose: To elucidate the impact of mild posterior capsule opacification (PCO) on the visual outcomes in patients with hydrophilic trifocal intraocular lens (IOLs), and to identify objective indicators that can assist in determining the need for neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. Methods: This is a prospective observational study. 189 patients implanted trifocal IOLs who underwent Nd:YAG laser posterior capsulotomy were recruited. Patients were classified into four grades according to PCO morphology. The distance, intermediate, and near visual acuity (VA), dysfunction lens index (DLI), contrast sensitivity (CS) and visual function (VF-14) scores were measured before and 1 month after Nd:YAG laser capsulotomy. Results: Before Nd:YAG laser capsulotomy, a significant correlation was observed between PCO grading and uncorrected distance VA (UDVA), uncorrected intermediate VA (UIVA), uncorrected near VA (UNVA) visual acuity, corrected distance VA (CDVA), DLI, and VF-14 scores (All P < 0.001). However, in patients with PCO grade 1 (mild), post-capsulotomy UNVA, DLI, medium and high spatial frequency CS under photopic condition and VF-14 scores were significantly improved compared with pre-capsulotomy values (all P < 0.05). The area under the receiver operating characteristic curve for DLI was 0.830 (P < 0.001), with a corresponding cut-off value of 7.225, indicating its usefulness in assessing the need for Nd:YAG laser capsulotomy in cases of mild PCO. Conclusions: Mild PCO initially impairs near visual acuity in patients with trifocal IOLs and concurrently diminishes both subjective and objective of visual quality. The DLI can serve as an auxiliary diagnostic indicator to assess whether patients with mild PCO may benefit from Nd:YAG laser capsulotomy.

Published in Advances in Ophthalmology Practice and Research

ISSN: 2667-3762 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Ophthalmology
Website: https://www.journals.elsevier.com/advances-in-ophthalmology-practice-and-research

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