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Methodologies for assessment of visual performance in pseudophakic patients under low illumination conditions

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Session Details

Session Title: Moderated Poster Session: New and Interesting

Venue: Poster Village: Pod 1

First Author: : S.Escandon-Garcia PORTUGAL

Co Author(s): :    F. Ribeiro   J. Gonzalez-Meijome           

Abstract Details


The purpose of this study was to apply different objective and subjective methodologies for the evaluation of visual performance using new metrics of visual performance under reducing illumination conditions in patients bilaterally implanted with multifocal and extended depth of focus intra-ocular lenses (IOLs) after cataract extraction and clear lens extraction using a prototype to measure light disturbances (LD).


Hospital da Luz, Lisbon, Portugal.


Candidates to cataract extraction (n=57) or clear lens extraction (n=17) with bilateral implantation of multifocal IOLs were enrolled in the present study after explanation of the purpose of the study and consent form acceptance. Distance visual acuity and defocus curves were measured under photopic conditions and contrast sensitivity function was measured without and with glare. LD were evaluated in a dark room with a prototype under monocular and binocular conditions. Subjective quality of vision was also assessed for frequency, severity and bothersome from 0 to 100. Evaluations were scheduled before, 1, 3 and 6 months after implantation.


In the cataract group light disturbance index decreased from 39±16% at 1 moth to 35±15% at 6 months visit (p=0.043) and a similar trend was observed in the QoV questionnaire decreasing from 49±16 to 43±12 from 1 to 6 months (p=0.008); Bothersome decreased even further from 37±19 to 21±17 from 1 to 6 months (p<0.001). In the clear lens group CSF under photopic and mesopic with glare shows a statistically significant improvement for frequency of 3.00 cycles per degree (p=0.032). Light disturbance under monocular conditions showed a significant increase (p=0,039).


With modern multifocal IOLs RLE is an effective technique in clear lens patients for presbyopic correction to achieve spectacle independence however, significant light distortion issues may subjectively reported specially after the first month after surgery. In spite of a stable near, intermediate and distance performance over the post-operative period, symptoms and objective metrics of visual performance under dim illumination conditions reveal an adaptation from 1 to 6 months that is stronger for the subjective perception of bothersome. In every visit, it was observed a binocular summation effect that reduced the LDI parameter and more significant at 1 month.

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