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Biomedical Optics Express

Biomedical Optics Express

  • Editor: Joseph A. Izatt
  • Vol. 4, Iss. 8 — Aug. 1, 2013
  • pp: 1294–1304
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Effects of glistenings in intraocular lenses

Marrie van der Mooren, Luuk Franssen, and Patricia Piers  »View Author Affiliations


Biomedical Optics Express, Vol. 4, Issue 8, pp. 1294-1304 (2013)
http://dx.doi.org/10.1364/BOE.4.001294


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Abstract

Glistenings consist of multiple microvacuoles in intraocular lenses (IOLs) that cause retinal stray light and may affect quality of vision. For four IOL types, the microvacuole particle size distribution and particle volume density was measured using confocal light microscopy and dark field microscopy, and the corresponding extinction coefficient γ was determined. The light scatter contribution induced by microvacuoles was measured as function of both angle and extinction, and was verified by calculations using Mie theory. Two IOL types possessed significant glistenings having stray light levels higher than that of a healthy 20 year old crystalline lens corresponding to γ ≥ 0.08 mm−1.

© 2013 OSA

1. Introduction

The phenomenon of inclusions or microvacuoles in intraocular lenses (IOLs) has been discussed extensively in ophthalmic literature for more than twenty five years. They are often referred to as glistenings due to their appearance when visualized e.g. in a slit-lamp exam. In our study, we consider a microvacuole to be a void located in the IOL bulk filled with the fluid surrounding the IOL. Glistenings are considered to be the visual effect caused by multiple microvacuoles. This study describes how light propagates through a lens containing such microvacuoles and discusses the effects on quality of vision based on the light intensity distribution as a function of retinal eccentricity.

Several papers report clinical studies investigating the impact of glistenings in intraocular lenses on contrast sensitivity (CS) and visual acuity (VA). In total, 6 studies examined the effect of glistenings on CS. Four of these studies reported that glistenings had a significant negative effect on the high spatial frequency CS [1

1. D. K. Dhaliwal, N. Mamalis, R. J. Olson, A. S. Crandall, P. Zimmerman, O. C. Alldredge, F. J. Durcan, and O. Omar, “Visual significance of glistenings seen in the AcrySof intraocular lens,” J. Cataract Refract. Surg. 22(4), 452–457 (1996). [CrossRef] [PubMed]

4

4. H. Minami, K. Toru, K. Hiroi, and S. Kazama, “Glistening of Acrylic Intraocular Lenses,” Rinsho Ganka 53(5), 991–994 (1999) (Jpn. J. Clin. Ophthalmol.).

] and two studies were non-conclusive [5

5. J. Colin and I. Orignac, “Glistenings on intraocular lenses in healthy eyes: effects and associations,” J. Refract. Surg. 27(12), 869–875 (2011). [CrossRef] [PubMed]

,6

6. G. Christiansen, F. J. Durcan, R. J. Olson, and K. Christiansen, “Glistenings in the AcrySof intraocular lens: pilot study,” J. Cataract Refract. Surg. 27(5), 728–733 (2001). [CrossRef] [PubMed]

]. While some studies do show a decrease in VA with increased severity of glistenings [6

6. G. Christiansen, F. J. Durcan, R. J. Olson, and K. Christiansen, “Glistenings in the AcrySof intraocular lens: pilot study,” J. Cataract Refract. Surg. 27(5), 728–733 (2001). [CrossRef] [PubMed]

,7

7. J. Colin, D. Praud, D. Touboul, and C. Schweitzer, “Incidence of glistenings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg. 38(7), 1140–1146 (2012). [CrossRef] [PubMed]

] the general consensus in the literature tends to be that visual acuity is unaffected by glistenings [1

1. D. K. Dhaliwal, N. Mamalis, R. J. Olson, A. S. Crandall, P. Zimmerman, O. C. Alldredge, F. J. Durcan, and O. Omar, “Visual significance of glistenings seen in the AcrySof intraocular lens,” J. Cataract Refract. Surg. 22(4), 452–457 (1996). [CrossRef] [PubMed]

3

3. A. Waite, N. Faulkner, and R. J. Olson, “Glistenings in the single-piece, hydrophobic, acrylic intraocular lenses,” Am. J. Ophthalmol. 144(1), 143–144 (2007). [CrossRef] [PubMed]

,5

5. J. Colin and I. Orignac, “Glistenings on intraocular lenses in healthy eyes: effects and associations,” J. Refract. Surg. 27(12), 869–875 (2011). [CrossRef] [PubMed]

,8

8. K. Hayashi, A. Hirata, M. Yoshida, K. Yoshimura, and H. Hayashi, “Long-term effect of surface light scattering and glistenings of intraocular lenses on visual function,” Am. J. Ophthalmol. 154(2), 240–251, e2 (2012). [CrossRef] [PubMed]

13

13. E. Mönestam and A. Behndig, “Impact on visual function from light scattering and glistenings in intraocular lenses, a long-term study,” Acta Ophthalmol. (Copenh.) 89(8), 724–728 (2011). [CrossRef] [PubMed]

]. These studies found no common conclusion concerning the effect of glistenings on measured visual quality. This may be due to the fact that quality of vision is not measurable in one comprehensive test and the aforementioned standard vision testing methodologies require only a very small part of the retina to respond to stimuli. In vitro studies report a positively correlated relationship between the total integrated light scatter and the severity of glistenings [14

14. D. H. Kim, R. H. James, R. J. Landry, D. Calogero, J. Anderson, and I. K. Ilev, “Quantification of glistenings in intraocular lenses using a ballistic-photon removing integrating-sphere method,” Appl. Opt. 50(35), 6461–6467 (2011). [CrossRef] [PubMed]

,15

15. T. Oshika, Y. Shiokawa, S. Amano, and K. Mitomo, “Influence of glistenings on the optical quality of acrylic foldable intraocular lens,” Br. J. Ophthalmol. 85(9), 1034–1037 (2001). [CrossRef] [PubMed]

]. Also, several in vivo studies found increased levels of intraocular stray light [8

8. K. Hayashi, A. Hirata, M. Yoshida, K. Yoshimura, and H. Hayashi, “Long-term effect of surface light scattering and glistenings of intraocular lenses on visual function,” Am. J. Ophthalmol. 154(2), 240–251, e2 (2012). [CrossRef] [PubMed]

,13

13. E. Mönestam and A. Behndig, “Impact on visual function from light scattering and glistenings in intraocular lenses, a long-term study,” Acta Ophthalmol. (Copenh.) 89(8), 724–728 (2011). [CrossRef] [PubMed]

,16

16. M. Nagata, H. Matsushima, K. Mukai, W. Terauchi, T. Senoo, H. Wada, and S. Yoshida, “Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics,” J. Cataract Refract. Surg. 36(12), 2056–2060 (2010). [CrossRef] [PubMed]

]. In vitro studies allow us to isolate the scatter contribution of the IOL from that of the ocular media. They enable the study of light scatter patterns from the patients’ perspective, i.e. in the forward direction, and also from the clinicians’ perspective, i.e. in the backward direction [17

17. M. van der Mooren, J. Coppens, M. Bandhauer, and T. van den Berg, “Light scatter characteristics of acrylic intraocular lenses,” Invest. Ophthalmol. Vis. Sci. 48, E-abstract 3126 (2007).

].

Absorption removes and scattering redirects energy from the propagating light beam forming the retinal image. The attenuation in light intensity of the original beam is called extinction and this phenomenon is described by Beer’s law. The transmitted light intensity decreases exponentially with the path length traveled by the propagating beam in a medium, in our case the IOL. Microvacuoles are almost completely transparent in visible light. For the visible wavelength range, absorption plays no role in light attenuation caused by the microvacuoles, and the effects measured are solely caused by scattering. In addition to light scatter measurements, it is also possible to perform light microscopy on the same IOL. In this paper, our aim is to relate microvacuole density and size distribution to light scatter as a function of visual angle based on Mie theory. Mie formulae are applied in various scientific fields from chemistry, medicine and astronomy to meteorology. The lunar corona shown in Fig. 1
Fig. 1 Lunar corona.
illustrates the optical effects of the clouds in front of the bright moon acting both as a grating and as a prism [18

18. L. Cowley, P. Laven, and M. Vollmer, “Rings around the sun and moon: coronae and diffraction,” Phys. Educ. 40(1), 51–59 (2005). [CrossRef]

].

The water droplets in a cloud separate the incident moon light into two optical fields. One field consists of the light diffracted by the surfaces of the water droplets creating a white halo and the other field traverses the water droplets creating colored fringes. The strength and size of the halo is determined by the density and size distribution of the water droplets. The lunar corona is an anomalous scattering pattern because it is composed of two optical fields. The water droplets in the cloud act similarly to the microvacuoles in the intraocular lenses. In this paper, methods used in atmospheric optics are applied for our specific investigation by adapting all parameters applicable such as refractive indices and particle distribution.

2. Materials and methods

The following sixteen hydrophobic acrylic IOLs were included in this study: five Acrysof IOLs (Alcon Laboratories Inc, Forth Worth, Texas, USA), three iSymm IOLs (HOYA Surgical Optics Inc, Singapore), three enVista IOLs (Bausch & Lomb, Rochester, New York, USA) and five Tecnis IOLs (Abbott Medical Optics Inc, Santa Ana, California, USA). All lenses were removed from their packages and directly immersed in saline solution in fluid cells. Microvacuoles were induced by taking the IOL from its room temperature environment and placing it into an oven at ocular temperature of 35 °C for a period of more than 8 hours. The lenses were removed from the oven for measurement at room temperature. The densities of induced microvacuoles vary with the time following their removal from the oven. For this reason, restrictions were made with respect to the time points of measurements. The light scatter measurements and lens imaging with confocal microscopy and dark field microscopy were performed within a two-hour period. Confocal microscopy has a limited depth of focus, as such multiple images were made throughout the thickness of the lens and the images were then stacked. It also has a small field of view resulting in the need for three or more lateral displacements across the lens in order to image the complete central optic body. Dark field microscopy is a setup where the intraocular lens is retro-illuminated with an annulus of light and has a large field of view. If there are no inclusions or other sources for light scatter, the image will be black. The Image J program was used to determine size and density of the microvacuoles from the stacked confocal microscopy images for dense populations or from dark field microscopy photographs for tiny populations of microvacuoles. The size distribution and density together with the indices of refraction for microvacuole and IOL material contribute to the extinction coefficient γ [mm−1], shortened to extinction in this paper. For each IOL γ was determined using Eq. (1) [19

19. H.C. van de Hulst, Light Scattering by Small Particles (Dover Publications Inc., 1981), pp. 129, 176, 222.

], where N(a) is the microvacuole size distribution per unit volume and “a” is the microvacuole radius and Q is the scatter extinction efficiency factor defined in Eq. (2) [19

19. H.C. van de Hulst, Light Scattering by Small Particles (Dover Publications Inc., 1981), pp. 129, 176, 222.

]. The phase lag ρ experienced by the central ray that passes through the full diameter of the microvacuole is 2ka|m-1|, where m is the ratio of the refractive indices of microvacuole and IOL material n. Wave number k is equal to 2πn/λ where λ is the wavelength of light used.
γ=0πa2Q(a)N(a)da
(1)
Q(ρ)=2(4/ρ)sinρ+(4/ρ2)(1cosρ)
(2)
Factor Q oscillates around the value of 2 illustrating the efficiency for light scatter in large particles. The oscillation damps with increasing phase lag.

2.1. Light scatter measurements

Using two lab-based methods, the scattered light intensity distribution was measured as a function of angle. These in vitro light scatter methods capturing the high dynamic angular and intensity range have previously been described by van der Mooren et al [20

20. M. van der Mooren, T. van den Berg, J. Coppens, and P. Piers, “Combining in vitro test methods for measuring light scatter in intraocular lenses,” Biomed. Opt. Express 2(3), 505–510 (2011). [CrossRef] [PubMed]

]. The output of these two methods is expressed in a scatter parameter s [deg2/sr] defined as point spread function PSF(θ) multiplied by the square of visual angle θ. In the first method used to make small angle measurements, an artificial cornea was included in order to measure physiologically realistic stray light contributions close to the focal point. The second method that measures at angles larger than three degrees is able to measure the forward and backward scatter. The measured outcomes were compared with the light scatter levels for 20 yr and 70 yr old healthy crystalline lenses.

To isolate the light scatter induced by the microvacuoles, light scatter measurements with and without microvacuole induction were subtracted from each other. These results were compared to calculations using implemented Mie theory in the MIEPlot software program [21

21. P. Laven, “MiePlot: A computer program for scattering of light from a sphere using Mie theory & the Debye series,” http://www.philiplaven.com/mieplot.htm, accessed January 2013.

]. The measured particle distributions were introduced in the program together with the refractive indices for the IOL materials, and n = 1.33 for the microvacuoles. The MIEplot software program outputs the angular intensity distribution I(θ) over 360 degrees with a chosen angular resolution of 0.1 degrees, and is normalized to 1 by integration over the forward hemisphere. The fraction of the incident light intensity which was scattered is defined in Eq. (3) where t is the thickness of the lens.
f(γ)=1exp(γt)
(3)
The scatter function was then calculated by multiplying this fraction by the normalized intensity distribution and the angle squared as shown in Eq. (4).
s(θ,γ)=f(γ)I(θ)θ2
(4)
Furthermore, the calculated intensity distribution I(θ) outcome was verified with Mie theory using Eq. (5). The formula consists of the sum of a refracted part [19

19. H.C. van de Hulst, Light Scattering by Small Particles (Dover Publications Inc., 1981), pp. 129, 176, 222.

] with μ = m-1 and x = ka and the Fraunhofer diffraction pattern described by the standard Bessel function J1.

I(θ)=4μ2x2/(4μ2+θ2)2+x4((1+cosθ/2)2(J1(xsinθ)/xsinθ)2
(5)

2.2. Simulated visual effect

Light transmittance through an IOL is of importance for maintaining contrast throughput. The portion of the incoming light that is scattered over the retina reduces image contrast. In this study, the light transmission through an IOL was calculated as a function of extinction. Fresnel reflections, blue and UV filters and other features affecting light transmission were excluded and only the effect of the presence of microvacuoles was assessed. For all lenses that followed the procedure for microvacuole induction, the fraction of light intensity left for image formation was calculated as exp(-γt) and expressed as the percentage of light transmission for t = 0.5mm.

3. Results

An overview of the lenses tested is given in Fig. 2
Fig. 2 Microvacuole characteristics. The error bars indicate the standard deviation. The numbers of microvacuoles per cubic millimeter for the enVista IOLs and the Tecnis IOLs are so small that the bars are hardly visible.
together with their measured microvacuole characteristics.The lenses were tested on one of the two available stray light methods due to time constraints of the methodology. The top row of Fig. 3
Fig. 3 Top row shows dark field images and bottom row confocal images. The range of the extinction coefficients is displayed in between rows. The images from left to right with γ = 0.11 mm−1, γ = 0.00 mm−1, γ = 0.18 mm−1 and γ = 0.02 mm−1. Bar indicates 50 μm.
displays dark field images that correspond to the confocal microscopy images shown in the bottom row for all four types of IOLs.

The microvacuoles are non-spherical and an effective diameter is used to characterize the size while the non-uniformity of sizes is characterized by the standard deviation. For the Acrysof lenses the number of microvacuoles ranged from 46 to 3862 per cubic mm. The number of microvacuoles for the iSymm IOLs ranged from 2545 to 6495 per cubic mm, for the enVista IOLs 3 to 6 microvacuoles per cubic mm were found and the number for the Tecnis lenses ranged from 12 to 36 microvacuoles per cubic mm. The microvacuoles in the enVista IOLs had an effective diameter of approximately 33 μm and in the Tecnis IOLs 25 μm while the sizes in the iSymm IOLs and Acrysof IOLs were significantly smaller, 5.2 μm and 6.2 μm, respectively. For all cases, the standard deviation is approximately 30% of the average microvacuole diameter. The phase lag ρ was larger than 5 for all cases, and the scatter efficiency factor Q was equal to 2 for all lenses. This means that for all lenses the refracted scatter is incoherent, and that twice the intensity incident on a microvacuole was scattered. The extinction was calculated according to Eq. (1) for all IOLs and ranged from 0.02 to 0.24 mm−1 for Acrysof lenses. For the enVista IOLs γ ranged from 0.00 to 0.01 mm−1, for the iSymm IOLs γ ranged from 0.18 to 0.25 mm−1, and for the Tecnis lenses γ ranged from 0.01 to 0.04 mm−1.

3.1. Light scatter measurements

Figure 4
Fig. 4 Scatter level as a function of visual angle compared to a 20 yr and a 70 yr old healthy crystalline lens. The numbers in the legend denote extinction and symbols in the graph denote the IOL type (■Acrysof, ●enVista, ◊ and ♦iSymm, ▲Tecnis). The low angle measurements are represented with symbols; the actual measurements have much higher resolution.
displays all light scatter measurement results after microvacuole induction and are labeled with the corresponding measured extinctions that can be found in the legend.

The scatter measurements at three degrees showed a higher than expected outcome because of the large angular width (1.2 degrees) of the camera aperture [20

20. M. van der Mooren, T. van den Berg, J. Coppens, and P. Piers, “Combining in vitro test methods for measuring light scatter in intraocular lenses,” Biomed. Opt. Express 2(3), 505–510 (2011). [CrossRef] [PubMed]

] relative to the measurement angle. In that study [20

20. M. van der Mooren, T. van den Berg, J. Coppens, and P. Piers, “Combining in vitro test methods for measuring light scatter in intraocular lenses,” Biomed. Opt. Express 2(3), 505–510 (2011). [CrossRef] [PubMed]

] the measurement result performed on one lens without any glistenings on both setups agreed well. In Fig. 4 the measurement results of both methods are displayed for different lenses with different levels of glistenings, and the results of both methods agree well with theory as shown in Fig. 5
Fig. 5 Induced light scatter of two small-angle (solid black line γ = 0.11 mm−1 and solid red line γ = 0.18 mm−1) and two large-angle measurements (symbols: γ = 0.12 mm−1 and γ = 0.24 mm−1) compared to two outcomes using MIEPlot program for γ = 0.11 and 0.24 mm−1 (dashed).
and will be described later. For the lenses which have low extinctions the results between the two methods deviate due to very low signal levels, but are well below the level of a 20 yr old crystalline lens.

In general, it is found that when γ is smaller than 0.08 mm−1, the light scatter is less than that of a 20 yr old crystalline lens, and when γ is larger than approximately 0.25 mm−1, the light scatter is more than that of a 70 yr old crystalline lens. For extinctions between 0.08 mm−1 and 0.25 mm−1, the light scatter level is between that of a 20 yr old and 70 yr old crystalline lens.

Two scatter functions s(θ, γ = 0.11) and s(θ, γ = 0.24) calculated using MIEplot for microvacuoles with an average diameter of 6 μm and a standard deviation of 2 μm are displayed in Fig. 5. The stray light function shows two peaks, one at two degrees and a broader peak at 15 degrees. These calculations compare well to the optical scatter levels induced, obtained from the subtraction of measurements results after and before microvacuole induction.

The lower scatter angle measurements show lower peaks and narrower widths than the calculations. It is important to take note of the fact that the results are displayed on a log-log scale and the difference in width is within 1 degree, and the peak difference is approximately 1 deg2/sr. The measured red curve had an extinction of 0.18 mm−1, and the peak is as expected in between the calculated values of 0.11 mm−1 and 0.24 mm−1.

The decomposed scatter intensity outcomes of the MIEplot program compare well with MIE-theory formulated in Eq. (5). The peak at two degrees is caused by diffraction and the peak at 15 degrees by refraction of light traversing the microvacuoles.

3.2. Simulated visual effect

In Fig. 6
Fig. 6 Backward (left) and Forward (right) scatter for Acrysof lens at 45 degrees [17].
, an Acrysof IOL is shown viewed with slit illumination at 45 degrees in the forward and backward direction, and both images were scaled to the same intensity level. The calculated intensity ratio between forward and backward scatter for this angle is 390.

For all lenses with microvacuoles, light intensity transmission is calculated using Beer’s law shown in Fig. 7
Fig. 7 Light transmission (%) left for image formation.
. The enVista IOL transmitted 100%, the four Tecnis IOLs at least 98%, the two iSymm IOLs transmitted approximately 90%, and the Acrysof IOLs show a variable performance level between 89% and 99%. This can be seen as the percentage of light remaining for image formation.

The results of the luminance contrast calculations are shown in Fig. 8
Fig. 8 Luminance contrast as a function of extinction for three common daily tasks. Labels refer to the lighting conditions defined in Table 1.
for each set of lighting conditions presented in Table 1. In each case, the contrast decreases with increasing level of extinction. For an extinction of 0.15 mm−1, the contrast dropped 19%, 17% and 15% respectively for case 1, 2 and 3 compared to an IOL with no microvacuoles. For case 3, the background luminance is very small compared to the target luminance and the contrast is determined by Lt/Lv. In this case, the contrast reduction can be determined directly from the light intensity transmission graph (Fig. 7). When γ = 0.15 mm−1, the intensity transmittance for image formation is 92.5%. Correspondingly, the light scattered is 7.5%, which is half of the percentage of the contrast reduction.

4. Discussion

We acknowledge that our investigational technique is not necessarily an exact simulation of how all investigated IOLs will respond in vivo. Microvacuole induction in IOLs is a dynamic process and the applied time constraints for measurements were necessary to investigate the relationship between the determined extinctions and measured light scatter levels. A controlled waiting period was used directly after the lens had been removed from the oven (eye temperature) to allow for the condensation formation to disappear. During induction, it was observed that the microvacuoles originate from the center of the lens and spread out towards the periphery of the lens optic. When the lens is in a constant temperature environment for more than a day, all microvacuoles disappear. The material close to the edges and lens surfaces is free from the microvacuoles that are denser close to the visual axis (Fig. 9
Fig. 9 Dark field images Acrysof lens 10X (left) and 40X (right).
).

Most clinical studies report that glistenings have no effect on visual acuity. This can be explained by the induced scatter function obtained as a function of visual angle as shown in Fig. 5. A visual acuity of 20/20 corresponds to less than 0.02 degrees of visual angle. For the small angles used in VA measurements, scatter plays a less significant role than for larger angles. This changes when target luminance and target contrast are low causing reduced retinal image contrast due to the lower light transmission for image formation. This conclusion is supported by studies that show a decrease in contrast sensitivity especially for higher spatial frequencies. For the higher spatial frequencies, the contrast sensitivity is lowest. Standard contrast vision tests have steps between consecutive levels of 40%. Not all studies find an effect for all spatial frequencies because in order to consistently illustrate the effect of stray light for these viewing conditions, extinction levels of at least 0.20 mm−1are necessary. To consistently measure the clinical effect of glistenings on vision, contrast steps smaller than 40% should be used. Additionally, low-contrast examinations with low luminance, or contrast tests where the glare source is positioned at angles close to that of the scatter function maxima, could also illustrate the effect of glistenings.

In summary, the size, distribution, and density, together with the indices of refraction for microvacuoles and IOL materials contribute to the extinction coefficient γ. We have shown that glistenings can be quantified in this one parameter, the extinction coefficient, and that their impact on contrast vision can be simulated using the veiling luminance. The iSymm IOLs and the majority of the Acrysof IOLs showed significant levels of glistenings. It can be concluded that IOL manufacturers should consider evaluating IOL stray light as a standard procedure in the release of new IOL models. In addition, it can be concluded that in order to ensure that glistenings do not cause a significant increase in stray light, the extinction coefficient should remain below 0.08 mm−1, that which results in a stray light level equivalent to a 20 yr old healthy crystalline lens.

Acknowledgments

The authors acknowledge Tom van den Berg, Michelle Langeslag and Joris Coppens for their contributions to this paper. We acknowledge financial support from EUREKA grant INT 111017.

References and links

1.

D. K. Dhaliwal, N. Mamalis, R. J. Olson, A. S. Crandall, P. Zimmerman, O. C. Alldredge, F. J. Durcan, and O. Omar, “Visual significance of glistenings seen in the AcrySof intraocular lens,” J. Cataract Refract. Surg. 22(4), 452–457 (1996). [CrossRef] [PubMed]

2.

U. Gunenc, F. H. Oner, S. Tongal, and M. Ferliel, “Effects on visual function of glistenings and folding marks in AcrySof intraocular lenses,” J. Cataract Refract. Surg. 27(10), 1611–1614 (2001). [CrossRef] [PubMed]

3.

A. Waite, N. Faulkner, and R. J. Olson, “Glistenings in the single-piece, hydrophobic, acrylic intraocular lenses,” Am. J. Ophthalmol. 144(1), 143–144 (2007). [CrossRef] [PubMed]

4.

H. Minami, K. Toru, K. Hiroi, and S. Kazama, “Glistening of Acrylic Intraocular Lenses,” Rinsho Ganka 53(5), 991–994 (1999) (Jpn. J. Clin. Ophthalmol.).

5.

J. Colin and I. Orignac, “Glistenings on intraocular lenses in healthy eyes: effects and associations,” J. Refract. Surg. 27(12), 869–875 (2011). [CrossRef] [PubMed]

6.

G. Christiansen, F. J. Durcan, R. J. Olson, and K. Christiansen, “Glistenings in the AcrySof intraocular lens: pilot study,” J. Cataract Refract. Surg. 27(5), 728–733 (2001). [CrossRef] [PubMed]

7.

J. Colin, D. Praud, D. Touboul, and C. Schweitzer, “Incidence of glistenings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg. 38(7), 1140–1146 (2012). [CrossRef] [PubMed]

8.

K. Hayashi, A. Hirata, M. Yoshida, K. Yoshimura, and H. Hayashi, “Long-term effect of surface light scattering and glistenings of intraocular lenses on visual function,” Am. J. Ophthalmol. 154(2), 240–251, e2 (2012). [CrossRef] [PubMed]

9.

J. Colin, I. Orignac, and D. Touboul, “Glistenings in a large series of hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg. 35(12), 2121–2126 (2009). [CrossRef] [PubMed]

10.

J. Moreno-Montañés, A. Alvarez, R. Rodríguez-Conde, and A. Fernández-Hortelano, “Clinical factors related to the frequency and intensity of glistenings in AcrySof intraocular lenses,” J. Cataract Refract. Surg. 29(10), 1980–1984 (2003). [CrossRef] [PubMed]

11.

E. Wilkins and R. J. Olson, “Glistenings with long-term follow-up of the Surgidev B20/20 polymethylmethacrylate intraocular lens,” Am. J. Ophthalmol. 132(5), 783–785 (2001). [CrossRef] [PubMed]

12.

L. Werner, “Glistenings and surface light scattering in intraocular lenses,” J. Cataract Refract. Surg. 36(8), 1398–1420 (2010). [CrossRef] [PubMed]

13.

E. Mönestam and A. Behndig, “Impact on visual function from light scattering and glistenings in intraocular lenses, a long-term study,” Acta Ophthalmol. (Copenh.) 89(8), 724–728 (2011). [CrossRef] [PubMed]

14.

D. H. Kim, R. H. James, R. J. Landry, D. Calogero, J. Anderson, and I. K. Ilev, “Quantification of glistenings in intraocular lenses using a ballistic-photon removing integrating-sphere method,” Appl. Opt. 50(35), 6461–6467 (2011). [CrossRef] [PubMed]

15.

T. Oshika, Y. Shiokawa, S. Amano, and K. Mitomo, “Influence of glistenings on the optical quality of acrylic foldable intraocular lens,” Br. J. Ophthalmol. 85(9), 1034–1037 (2001). [CrossRef] [PubMed]

16.

M. Nagata, H. Matsushima, K. Mukai, W. Terauchi, T. Senoo, H. Wada, and S. Yoshida, “Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics,” J. Cataract Refract. Surg. 36(12), 2056–2060 (2010). [CrossRef] [PubMed]

17.

M. van der Mooren, J. Coppens, M. Bandhauer, and T. van den Berg, “Light scatter characteristics of acrylic intraocular lenses,” Invest. Ophthalmol. Vis. Sci. 48, E-abstract 3126 (2007).

18.

L. Cowley, P. Laven, and M. Vollmer, “Rings around the sun and moon: coronae and diffraction,” Phys. Educ. 40(1), 51–59 (2005). [CrossRef]

19.

H.C. van de Hulst, Light Scattering by Small Particles (Dover Publications Inc., 1981), pp. 129, 176, 222.

20.

M. van der Mooren, T. van den Berg, J. Coppens, and P. Piers, “Combining in vitro test methods for measuring light scatter in intraocular lenses,” Biomed. Opt. Express 2(3), 505–510 (2011). [CrossRef] [PubMed]

21.

P. Laven, “MiePlot: A computer program for scattering of light from a sphere using Mie theory & the Debye series,” http://www.philiplaven.com/mieplot.htm, accessed January 2013.

22.

L. L. Holladay, “The fundamentals of glare and visibility,” J. Opt. Soc. Am. 12(4), 271–319 (1926). [CrossRef]

23.

T. J. Van Den Berg, L. J. Van Rijn, R. Michael, C. Heine, T. Coeckelbergh, C. Nischler, H. Wilhelm, G. Grabner, M. Emesz, R. I. Barraquer, J. E. Coppens, and L. Franssen, “Straylight effects with aging and lens extraction,” Am. J. Ophthalmol. 144(3), 358–363, 363.e1 (2007). [CrossRef] [PubMed]

24.

E. Peetermans and R. Hennekes, “Long-term results of wagon wheel packed acrylic intra-ocular lenses (AcrySof),” Bull. Soc. Belge Ophtalmol. 271, 45–48 (1999). [PubMed]

25.

D. Tognetto, L. Toto, G. Sanguinetti, and G. Ravalico, “Glistenings in foldable intraocular lenses,” J. Cataract Refract. Surg. 28(7), 1211–1216 (2002). [CrossRef] [PubMed]

26.

S. Yoshida, H. Matsushima, M. Nagata, T. Senoo, I. Ota, and K. Miyake, “Decreased visual function due to high-level light scattering in a hydrophobic acrylic intraocular lens,” Jpn. J. Ophthalmol. 55(1), 62–66 (2011). [CrossRef] [PubMed]

27.

N. Z. Gregori, T. S. Spencer, N. Mamalis, and R. J. Olson, “In vitro comparison of glistening formation among hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg. 28(7), 1262–1268 (2002). [CrossRef] [PubMed]

28.

H. Nishihara, S. Yaguchi, T. Onishi, M. Chida, and M. Ayaki, “Surface scattering in implanted hydrophobic intraocular lenses,” J. Cataract Refract. Surg. 29(7), 1385–1388 (2003). [CrossRef] [PubMed]

29.

H. Nishihara, M. Ayaki, T. Watanabe, T. Ohnishi, T. Kageyama, and S. Yaguchi, “Comparison of surface light scattering of acrylic intraocular lenses made by lathe-cutting and cast-molding methods—long-term observation and experimental study,” Nippon Ganka Gakkai Zasshi 108(3), 157–161 (2004) (article in Japanese). [PubMed]

30.

S. Yaguchi, H. Nishihara, W. Kambhiranond, D. Stanley, and D. J. Apple, “Light scatter on the surface of AcrySof intraocular lenses: part I. Analysis of lenses retrieved from pseudophakic postmortem human eyes,” Ophthalmic Surg. Lasers Imaging 39(3), 209–213 (2008). [CrossRef] [PubMed]

31.

K. Miyata, S. Otani, R. Nejima, T. Miyai, T. Samejima, M. Honbo, K. Minami, and S. Amano, “Comparison of postoperative surface light scattering of different intraocular lenses,” Br. J. Ophthalmol. 93(5), 684–687 (2009). [CrossRef] [PubMed]

32.

H. Matsushima, K. Mukai, M. Nagata, N. Gotoh, E. Matsui, and T. Senoo, “Analysis of surface whitening of extracted hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg. 35(11), 1927–1934 (2009). [CrossRef] [PubMed]

33.

K. Miyata, M. Honbo, S. Otani, R. Nejima, and K. Minami, “Effect on visual acuity of increased surface light scattering in intraocular lenses,” J. Cataract Refract. Surg. 38(2), 221–226 (2012). [CrossRef] [PubMed]

OCIS Codes
(330.4460) Vision, color, and visual optics : Ophthalmic optics and devices
(290.2648) Scattering : Stray light
(330.4595) Vision, color, and visual optics : Optical effects on vision

ToC Category:
Ophthalmology Applications

History
Original Manuscript: May 21, 2013
Revised Manuscript: June 27, 2013
Manuscript Accepted: July 8, 2013
Published: July 11, 2013

Citation
Marrie van der Mooren, Luuk Franssen, and Patricia Piers, "Effects of glistenings in intraocular lenses," Biomed. Opt. Express 4, 1294-1304 (2013)
http://www.opticsinfobase.org/boe/abstract.cfm?URI=boe-4-8-1294


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References

  1. D. K. Dhaliwal, N. Mamalis, R. J. Olson, A. S. Crandall, P. Zimmerman, O. C. Alldredge, F. J. Durcan, and O. Omar, “Visual significance of glistenings seen in the AcrySof intraocular lens,” J. Cataract Refract. Surg.22(4), 452–457 (1996). [CrossRef] [PubMed]
  2. U. Gunenc, F. H. Oner, S. Tongal, and M. Ferliel, “Effects on visual function of glistenings and folding marks in AcrySof intraocular lenses,” J. Cataract Refract. Surg.27(10), 1611–1614 (2001). [CrossRef] [PubMed]
  3. A. Waite, N. Faulkner, and R. J. Olson, “Glistenings in the single-piece, hydrophobic, acrylic intraocular lenses,” Am. J. Ophthalmol.144(1), 143–144 (2007). [CrossRef] [PubMed]
  4. H. Minami, K. Toru, K. Hiroi, and S. Kazama, “Glistening of Acrylic Intraocular Lenses,” Rinsho Ganka53(5), 991–994 (1999) (Jpn. J. Clin. Ophthalmol.).
  5. J. Colin and I. Orignac, “Glistenings on intraocular lenses in healthy eyes: effects and associations,” J. Refract. Surg.27(12), 869–875 (2011). [CrossRef] [PubMed]
  6. G. Christiansen, F. J. Durcan, R. J. Olson, and K. Christiansen, “Glistenings in the AcrySof intraocular lens: pilot study,” J. Cataract Refract. Surg.27(5), 728–733 (2001). [CrossRef] [PubMed]
  7. J. Colin, D. Praud, D. Touboul, and C. Schweitzer, “Incidence of glistenings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg.38(7), 1140–1146 (2012). [CrossRef] [PubMed]
  8. K. Hayashi, A. Hirata, M. Yoshida, K. Yoshimura, and H. Hayashi, “Long-term effect of surface light scattering and glistenings of intraocular lenses on visual function,” Am. J. Ophthalmol.154(2), 240–251, e2 (2012). [CrossRef] [PubMed]
  9. J. Colin, I. Orignac, and D. Touboul, “Glistenings in a large series of hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg.35(12), 2121–2126 (2009). [CrossRef] [PubMed]
  10. J. Moreno-Montañés, A. Alvarez, R. Rodríguez-Conde, and A. Fernández-Hortelano, “Clinical factors related to the frequency and intensity of glistenings in AcrySof intraocular lenses,” J. Cataract Refract. Surg.29(10), 1980–1984 (2003). [CrossRef] [PubMed]
  11. E. Wilkins and R. J. Olson, “Glistenings with long-term follow-up of the Surgidev B20/20 polymethylmethacrylate intraocular lens,” Am. J. Ophthalmol.132(5), 783–785 (2001). [CrossRef] [PubMed]
  12. L. Werner, “Glistenings and surface light scattering in intraocular lenses,” J. Cataract Refract. Surg.36(8), 1398–1420 (2010). [CrossRef] [PubMed]
  13. E. Mönestam and A. Behndig, “Impact on visual function from light scattering and glistenings in intraocular lenses, a long-term study,” Acta Ophthalmol. (Copenh.)89(8), 724–728 (2011). [CrossRef] [PubMed]
  14. D. H. Kim, R. H. James, R. J. Landry, D. Calogero, J. Anderson, and I. K. Ilev, “Quantification of glistenings in intraocular lenses using a ballistic-photon removing integrating-sphere method,” Appl. Opt.50(35), 6461–6467 (2011). [CrossRef] [PubMed]
  15. T. Oshika, Y. Shiokawa, S. Amano, and K. Mitomo, “Influence of glistenings on the optical quality of acrylic foldable intraocular lens,” Br. J. Ophthalmol.85(9), 1034–1037 (2001). [CrossRef] [PubMed]
  16. M. Nagata, H. Matsushima, K. Mukai, W. Terauchi, T. Senoo, H. Wada, and S. Yoshida, “Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics,” J. Cataract Refract. Surg.36(12), 2056–2060 (2010). [CrossRef] [PubMed]
  17. M. van der Mooren, J. Coppens, M. Bandhauer, and T. van den Berg, “Light scatter characteristics of acrylic intraocular lenses,” Invest. Ophthalmol. Vis. Sci.48, E-abstract 3126 (2007).
  18. L. Cowley, P. Laven, and M. Vollmer, “Rings around the sun and moon: coronae and diffraction,” Phys. Educ.40(1), 51–59 (2005). [CrossRef]
  19. H.C. van de Hulst, Light Scattering by Small Particles (Dover Publications Inc., 1981), pp. 129, 176, 222.
  20. M. van der Mooren, T. van den Berg, J. Coppens, and P. Piers, “Combining in vitro test methods for measuring light scatter in intraocular lenses,” Biomed. Opt. Express2(3), 505–510 (2011). [CrossRef] [PubMed]
  21. P. Laven, “MiePlot: A computer program for scattering of light from a sphere using Mie theory & the Debye series,” http://www.philiplaven.com/mieplot.htm , accessed January 2013.
  22. L. L. Holladay, “The fundamentals of glare and visibility,” J. Opt. Soc. Am.12(4), 271–319 (1926). [CrossRef]
  23. T. J. Van Den Berg, L. J. Van Rijn, R. Michael, C. Heine, T. Coeckelbergh, C. Nischler, H. Wilhelm, G. Grabner, M. Emesz, R. I. Barraquer, J. E. Coppens, and L. Franssen, “Straylight effects with aging and lens extraction,” Am. J. Ophthalmol.144(3), 358–363, 363.e1 (2007). [CrossRef] [PubMed]
  24. E. Peetermans and R. Hennekes, “Long-term results of wagon wheel packed acrylic intra-ocular lenses (AcrySof),” Bull. Soc. Belge Ophtalmol.271, 45–48 (1999). [PubMed]
  25. D. Tognetto, L. Toto, G. Sanguinetti, and G. Ravalico, “Glistenings in foldable intraocular lenses,” J. Cataract Refract. Surg.28(7), 1211–1216 (2002). [CrossRef] [PubMed]
  26. S. Yoshida, H. Matsushima, M. Nagata, T. Senoo, I. Ota, and K. Miyake, “Decreased visual function due to high-level light scattering in a hydrophobic acrylic intraocular lens,” Jpn. J. Ophthalmol.55(1), 62–66 (2011). [CrossRef] [PubMed]
  27. N. Z. Gregori, T. S. Spencer, N. Mamalis, and R. J. Olson, “In vitro comparison of glistening formation among hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg.28(7), 1262–1268 (2002). [CrossRef] [PubMed]
  28. H. Nishihara, S. Yaguchi, T. Onishi, M. Chida, and M. Ayaki, “Surface scattering in implanted hydrophobic intraocular lenses,” J. Cataract Refract. Surg.29(7), 1385–1388 (2003). [CrossRef] [PubMed]
  29. H. Nishihara, M. Ayaki, T. Watanabe, T. Ohnishi, T. Kageyama, and S. Yaguchi, “Comparison of surface light scattering of acrylic intraocular lenses made by lathe-cutting and cast-molding methods—long-term observation and experimental study,” Nippon Ganka Gakkai Zasshi108(3), 157–161 (2004) (article in Japanese). [PubMed]
  30. S. Yaguchi, H. Nishihara, W. Kambhiranond, D. Stanley, and D. J. Apple, “Light scatter on the surface of AcrySof intraocular lenses: part I. Analysis of lenses retrieved from pseudophakic postmortem human eyes,” Ophthalmic Surg. Lasers Imaging39(3), 209–213 (2008). [CrossRef] [PubMed]
  31. K. Miyata, S. Otani, R. Nejima, T. Miyai, T. Samejima, M. Honbo, K. Minami, and S. Amano, “Comparison of postoperative surface light scattering of different intraocular lenses,” Br. J. Ophthalmol.93(5), 684–687 (2009). [CrossRef] [PubMed]
  32. H. Matsushima, K. Mukai, M. Nagata, N. Gotoh, E. Matsui, and T. Senoo, “Analysis of surface whitening of extracted hydrophobic acrylic intraocular lenses,” J. Cataract Refract. Surg.35(11), 1927–1934 (2009). [CrossRef] [PubMed]
  33. K. Miyata, M. Honbo, S. Otani, R. Nejima, and K. Minami, “Effect on visual acuity of increased surface light scattering in intraocular lenses,” J. Cataract Refract. Surg.38(2), 221–226 (2012). [CrossRef] [PubMed]

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