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

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 caps...

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Main Authors: Limei Zhang, Runhan Shi, Xuanzhu Chen, Xuefen Gu, Jiying Shen, Aijun Wang, Shuang Ni, Lei Cai, Haike Guo, Jin Yang
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Advances in Ophthalmology Practice and Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667376225000125
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author Limei Zhang
Runhan Shi
Xuanzhu Chen
Xuefen Gu
Jiying Shen
Aijun Wang
Shuang Ni
Lei Cai
Haike Guo
Jin Yang
author_facet Limei Zhang
Runhan Shi
Xuanzhu Chen
Xuefen Gu
Jiying Shen
Aijun Wang
Shuang Ni
Lei Cai
Haike Guo
Jin Yang
author_sort Limei Zhang
collection DOAJ
description 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.
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spelling doaj-art-c10e0933098e407a8ef8ef3b9a4763a42025-08-20T03:12:57ZengElsevierAdvances in Ophthalmology Practice and Research2667-37622025-05-015211712310.1016/j.aopr.2025.02.002Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective studyLimei Zhang0Runhan Shi1Xuanzhu Chen2Xuefen Gu3Jiying Shen4Aijun Wang5Shuang Ni6Lei Cai7Haike Guo8Jin Yang9Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, ChinaDepartment 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, ChinaDepartment of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, ChinaDepartment of Ophthalmology, Shanghai Xinshijie Eye Hospital, Shanghai, ChinaDepartment of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, ChinaDepartment of Ophthalmology, Shanghai Bright Eye Hospital, Shanghai, ChinaDepartment of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, ChinaDepartment 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, ChinaDepartment of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China; Corresponding author. 83 Fenyang Road, Xuhui Direct, Shanghai, China.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.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.http://www.sciencedirect.com/science/article/pii/S2667376225000125Posterior capsule opacificationTrifocal diffractive intraocular lensDysfunction lens indexVisual function
spellingShingle Limei Zhang
Runhan Shi
Xuanzhu Chen
Xuefen Gu
Jiying Shen
Aijun Wang
Shuang Ni
Lei Cai
Haike Guo
Jin Yang
Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
Advances in Ophthalmology Practice and Research
Posterior capsule opacification
Trifocal diffractive intraocular lens
Dysfunction lens index
Visual function
title Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
title_full Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
title_fullStr Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
title_full_unstemmed Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
title_short Effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes: A multicenter prospective study
title_sort effect of mild posterior capsule opacification on visual outcomes in trifocal diffractive pseudophakic eyes a multicenter prospective study
topic Posterior capsule opacification
Trifocal diffractive intraocular lens
Dysfunction lens index
Visual function
url http://www.sciencedirect.com/science/article/pii/S2667376225000125
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