Polarised glasses counter IOL glistening?

A small study has found polarised glasses can help patients with intraocular lenses (IOLs) who develop glistening.

 

The peer-reviewed study, conducted by a clinic in Austria and published in Clinical Optometry, said corrective eyewear in patients with good visual acuity was the first step for patients experiencing unwanted visual symptoms and a referral for an explant should be reserved only for severe cases.

 

With polarised or edge filter (blue-light blocking) glasses they found contrast sensitivity improved on average by 0.28 log units (approximately 1 line on Pelli-Robson chart). Patients noted slight improvement in the size of halo (from 61±17 to 50±14) and glare (from 20±11 to 16±9), but considerable improvement in the intensity, which reduced approximately 50% (halo intensity reduced from 50±19 to 24±12 and glare intensity from 26±18 to 11±6). In two cases, explantation of the IOL was considered, but with good visual acuity, patients were discouraged due to the risks associated with the lens exchange.

 

The study followed six symptomatic patients who had undergone implantation of a hydrophobic acrylic mononofocal, multifocal or toric IOL for visually significant cataract at least six months prior. These patients had very reasonable corrected visual acuity (0.8–1.0 decimal) but had reduced contrast sensitivity and modulation transfer function, complained of visual phenomena and were dissatisfied with their visual status. They indicated the symptoms were not present immediately after surgery, but gradually developed postoperatively. Slit-lamp examination revealed moderate-to-severe glistening in all cases, the paper said.

 

The choice of IOL should not be based on subjective preference or economic aspects, but on well-founded scientific evidence, the authors added. They said practitioners should provide long-term care to assess the performance of IOLs because many aspects such as glistening, centration or PCO susceptibility were not obvious at early postoperative aftercare visits. Opticians and ophthalmologists should work in collaboration when managing such patients, they added.

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