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Purpose: The study aimed to investigate the correlation between the change of sex hormone levels and ocular surface parameters in girls with idiopathic central precocious puberty(ICPP). Methods: Eighteen girls with ICPP and 18 age-matched normal girls participated in this study, all of the participants had undergone physical measurements, laboratory tests, imaging examination and ocular surface assessments. Results: The Objective Scatter Index (OSI) in the ICPP group was significantly higher than in the control group (P = 0.031), girls with ICPP showed slightly lower MNITBUT compared to the normal control group, although this difference was not statistically significant. Bivariate analysis revealed a positive association between estradiol and OSI (r=0.383, P=0.021), Additionally, in the study population, both Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) were negatively correlated with Mean noninvasive tear breakup time (MNITBUT) (r=-0.359, P=0.031)(r=-0.357, P=0.032). Conclusion: In comparison with the normal control group, alterations in the OSI were observed in girls with ICPP. This alteration may be associated with an elevation in estrogen levels. Although there was a slight non-significant decrease in NITBUT in ICPP girls, the negative correlation between LH and FSH with MNITBUT suggests new perspective for further investigation.

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PURPOSE: To evaluate the changes in ocular surface parameters during orthokeratology lens wear and determine their correlations with ocular discomfort symptoms. METHODS: Fifty individuals were enrolled in this prospective pilot study. Clinical evaluation of the ocular surface included the ocular surface disease index, slit-lamp examination, Keratograph 5M, optical quality analysis system, and corneal staining. After baseline examinations, clinical tests were performed at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after orthokeratology lens wear. Correlations between ocular discomfort symptoms and signs of ocular discomfort were evaluated. RESULTS: Overall ocular surface disease index score and two subscale scores (ocular symptoms and vision-related function) significantly increased at the 3-month visit (P < 0.05), and decreased to levels close to baseline at the12-month visit (P > 0.05). The basic objective scatter index and the mean tear film objective scatter index increased, peaking at 3-month visit (P < 0.05) and gradually decreased thereafter. The modulation transfer function cut-off significantly decreased at the 3-month visit (P < 0.05). During the 12-month study period, the overall ocular surface disease index score and vision-related function score were significantly and positively correlated with the basic objective scatter index and mean tear film objective scatter index (P < 0.05). After 1 week of lens wear, Grade 1 corneal staining increased to 16.4 %, mostly involving the central and inferior cornea. CONCLUSIONS: Orthokeratology lens wear increased ocular discomfort symptoms and decreased the function of tear film, mainly within 3 months of lens wear. Tear-related visual function parameters were correlated with ocular discomfort. A new parameter, tear film objective scatter index, measured with the optical quality analysis system, was more sensitive in detecting the quality and stability of tear film than traditional indicators.

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Aim: To evaluate the subjective visual functions of early cataracts patients and assess their surgical indications. Methods: Eyes were separated into a control group (Group A without cataract) and two early cataracts groups (Group B with 2.0 ≤ OSI < 3.0 and Group C with 3.0 ≤ OSI < 4.0). The objective scatter index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) values were applied to measure objective visual functions. The contrast sensitivity (CS) and scores of the questionnaires (QOL and VF-14) characterized subjective visual functions. Above visual functions were compared among three groups. Postoperative visual functions in Group B and C were analyzed to assess the outcome of surgery. Results: Ninety two subjects (126 eyes) were included in the study. All objective visual function in Group B were significantly better than Group C (all P < 0.01), but worse than Group A (all P < 0.01). Except for 1.5 c/d CS, subjective visual function in Group A were significantly better than Group B and C (all P < 0.05), but there was no significant differences between Group B and C. As for eyes that underwent surgery in Group B and C, all visual functions significantly improved after surgery (P < 0.05), except for 1.5 c/d CS in Group C. There were no significant differences among the three groups after surgery. Conclusion: The subjective visual function can be impaired in early cataracts patients with OSI < 3.0, whose objective visual functions were statistically better than patients with OSI ≥ 3.0. These patients can benefit equally from surgery as patients with OSI ≥ 3.0. Subjective visual functions can be used as surgical indications for these patients.

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INTRODUCTION: We performed a prospective, single-center, cohort study in order to evaluate the effects of vitrectomy with epiretinal membrane (ERM) peel on optical quality in patients with primary ERM. METHODS: Thirty patients treated for primary ERM by vitrectomy with ERM peel were included from our tertiary university hospital ophthalmology department. The main study outcome was a variation in optical quality parameters measured using the HD Analyzer™ between preoperative and 2-month postoperative evaluations in operated eyes. Optical quality parameters comprised point spread function (PSF) width at 10% and 50%, objective scatter index (OSI), and modulation transfer function (MTF) cutoff. Contralateral non-operated eyes were used as an internal control for measurement reproducibility. RESULTS: Mean PSF width at 10% (42.22 vs. 27.37 arc/min; p = 0.0002) and mean OSI (3.32 vs. 2.32; p = 0.0003) were significantly improved between pre- versus postoperative evaluations. Mean PSF width at 50% and mean MTF cutoff showed no changes. Subgroup analysis according to crystalline lens status gave similar results, demonstrating that improvements in mean PSF width at 10% and OSI were not lens-related. Non-operated eyes showed no changes in any of the parameters analyzed. CONCLUSION: Reduced light scattering measured by OSI indicates improved optical quality following vitrectomy with ERM peel among patients with primary ERM. OSI measurement could thus be a new parameter of interest in the preoperative assessment of primary ERM and other pre-vitrectomy assessments.

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BACKGROUND: In clinical practice, fluctuating vision or decreased quality of vision is a common complaint in DED patients. Our study was designed to investigate the change in dynamic optical quality in dry eye patients after the use of artificial tears. METHODS: Fifty-nine patients with dry eye disease (DED) and 31 control subjects were included in this prospective case-control study. There was no significant difference in age and sex between these two groups (P = 0.342, P = 0.847, respectively). Clinical evaluation of the ocular surface included Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), lipid layer thickness (LLT), and Schirmer I test. DED patients were divided into two groups, mild (31 patients) and severe (28 patients). The optical quality of the tear film was measured with the Optical Quality Analysis System (OQAS) using the mean objective scatter index (mean OSI), standard deviation of objective scatter index (SD-OSI) and modulation transfer function cut-off (MTF cut-off). After baseline examinations, one drop of artificial tears (ATs, carboxymethylcellulose ophthalmic solution, 0.5%) was instilled in both eyes, and optical quality parameters were measured again at 5 and 30 min following application of ATs. RESULTS: At baseline, the mean OSI was higher in the DED group (0.95 ± 0.54) than in controls (0.54 ± 0.23, P < 0.001). The SD-OSI was also significantly increased in DED patients (0.44 ± 0.71) compared to control subjects (0.12 ± 0.06, P = 0.003). Five minutes after AT instillation, mean OSI and SD-OSI decreased significantly in severe DED patients (P = 0.044; P = 0.018), remained unchanged in mild DED patients, and increased in the control group (P = 0.019; P < 0.001). Thirty minutes after AT instillation, no significant difference in optical quality parameters was observed among the three groups. CONCLUSION: The effect of ATs on optical quality in patients with DED may differ according to the severity of the disease. Measurement of optical quality might be a promising tool to evaluate the effects of various ATs and possibly individualize treatment in DED patients.

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Femtosecond laser small incision lenticule extraction(SMILE)is one of the most advanced corneal refractive operations at present. Different from other traditional corneal refractive operations, SMILE achieves minimally invasive and valveless operation. Therefore, the evaluation of postoperative visual quality of SMILE also has its own characteristics, at present, the latest research at home and abroad has confirmed that the naked eye vision can be significantly improved and the refractive status is stable after SMILE. However, there are different understandings of the objective visual quality indexes and their influencing factors, such as higher-order aberration, modulation transfer function cut off(MTF cut off)and objective scatter index(OSI)after SMILE. This paper reviews the postoperative visual quality and its influencing factors after SMILE to provide clinical help.

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A previous work has reported a methodology to quantify intraocular scattering using a high sensitivity double-pass instrument with a robust index, the frequency scatter index. The purpose of our study was to evaluate an adaptation of the frequency scatter index for use in clinical double-pass systems. A prospective observational study was carried out in a group of patients with nuclear cataracts (n = 52) and in a control group (n = 11) using conventional double-pass systems. The frequency scatter index and the objective scatter index were used to assess the scattering. The Spearman coefficient was calculated to assess the correlation between both indexes, obtained from the double-pass images. Simultaneous measurements were performed with a double-pass and with a Hartmann-Shack wavefront sensor in the control group. The root-mean-square wavefront error and the full width at half maximum of the double-pass image were used to quantify the residual aberrations introduced by the variations in pupil size and retinal eccentricity. Measurement in eyes with different grades of cataracts shows a strong correlation (ρ = 0.929, p < .0001) between the frequency scatter index and the objective scatter index. A certain degree of correlation was observed between the objective scatter index and the root-mean-square and between the objective scatter index and the full width at half maximum, both for measurements with a different pupillary diameter and with a different retinal eccentricity (p < .05). No relationship was observed between the frequency scatter index and the root-mean-square or between the frequency scatter index and the full width at half maximum (p > .05). We have introduced and evaluated an adaptation of a methodology proposed recently for the measurement of intraocular scattering using the double-pass technique with a robust index, which is less affected by ocular aberrations. The frequency scatter index can be applied to conventional double-pass instruments available in clinical environments.

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PURPOSE: The purpose of this study is to determine the correlation between subjective and optical measurements used during cataract evaluation, including the iTrace Dysfunctional Lens Index (DLI), the HD Analyzer Objective Scatter Index (OSI), Lens Opacities Classification System III (LOCS III), Visual Function-14 Questionnaire (VF-14), and the Pelli-Robson Contrast Sensitivity Chart (PRCSC). METHODS: Seventy eyes from 70 patients were enrolled, including all stages of age-related nuclear cataracts. The LOCS III-NO with a cutoff of 3.2 was chosen to divide the population into two groups. Eyes with corneal or retinal pathology were excluded. All patients were evaluated with the iTrace's DLI, HD Analyzer's OSI, LOCS III, VF-14, and the PRCSC during each follow-up visit. Correlation analyses were performed using Stata software, version 14.0, StataCorp. RESULTS: The LOCS III-NO, DLI, OSI, and VF-14 questionnaire each correlated moderately with the BCVA with a Spearman rho value of 0.37, - 0.45, 0.40, and - 0.35, respectively. The DLI correlated moderately with LOCS III-NO with a rho value of - 0.37 and with the VF-14 questionnaire with a rho value of 0.35. The OSI correlated with both the contrast sensitivity and DLI with a rho value of - 0.35 and - 0.55, respectively. CONCLUSIONS: The DLI correlated with cataract symptoms (measured by the VF-14 questionnaire) in addition to BCVA. The OSI correlated moderately with contrast sensitivity and BCVA. The highest correlation was between DLI and OSI.

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PURPOSE: To compare the efficacy of trehalose-HA eye drops versus 0.1% hyaluronic acid for the treatment of dry eye. METHODS: This prospective, comparative, contralateral eye study included sixty eligible patients (mean age 44.13 ± 14.53 years). Patients having a SPEED questionnaire score of 16 or above, objective scatter index (OSI) > 1 and non-invasive tear break up time (NIBUT) of 10 s or less were included in the study. Eyes were randomized to receive 0.1% hyaluronic acid (HA) in one eye and trehalose-HA eye drops in the contralateral eye. At baseline, 1- and 3-month follow-ups, OSI, NIBUT, MG loss, tear meniscus height (TMH) and tear film osmolarity (TFO) were evaluated using non-invasive modalities RESULTS: There was a statistically significant improvement in NIBUT, TMH, OSI, SPEED questionnaire score in the trehalose-HA compared to the 0.1% HA group at both 1- and 3-month visits (p < 0.05). In both the study groups, compared to the baseline, the mean values of TFO, MG loss, OSI and SPEED questionnaire score significantly reduced at 3 months (p < 0.05). The mean values of NIBUT and tear meniscus height on the other hand showed a significant increase compared to the baseline values (p < 0.05). Both drugs were well tolerated by the study participants without any significant ocular side effects. CONCLUSION: Trehalose-HA was found to be more effective than 0.1% HA eye drops in the management of symptomatic dry eye, as shown by significant reduction in NIBUT, TMH and OSI, when evaluated using non-invasive modalities of dry eye evaluation.

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Purpose: To determine the normal values and relationships between haloes and objective optical quality in healthy eyes. Methods: In this cross-sectional study, haloes, pupillary responses to light, and objective optical quality were measured with the optical quality analysis system (OQAS) and a vision monitor (MonCv3) in 138 right eyes of 138 healthy young men with mean spherical equivalent of 0.32 ± 0.47 D. Results: The mean disc halo size was 77.17 ± 25.03 arcmin. The mean objective optical quality values were as follows: objective scatter index (OSI), 0.58 ± 0.33; Strehl ratio (SR), 0.21 ± 0.05; modulation transfer function cutoff, 36.27 ± 7.98 cpd; OQAS value (OV)100%, 1.21 ± 0.27; OV20%, 0.91 ± 0.23; and OV9%, 0.59 ± 0.16. Disc halo size correlated independently with OSI (P < 0.001) and minimum pupil size (P = 0.003) by forward stepwise regression analysis (disc halo size = 16.60 + 26.24 × OSI + 11.34 × minimum pupil size; R2 value = 17.7%; F = 14.52; P < 0.001). Conclusions: Reference values for disc halo size and objective optical quality in healthy young subjects were established. Eyes with worse objective vision quality exhibited larger haloes. Translational Relevance: The study provided the knowledge and the relationships of OQAS and halo measurements from a well-defined group of healthy young subjects. Both measurements are useful in clinical practice to help quantify the vision quality and complement each other.

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PURPOSE: To evaluate the optical quality and tear film quality in patients with dry eye syndrome (DES) before and after using an intranasal neurostimulation device to stimulate tear production. METHODS: Cross-sectional review of 33 eyes in 21 patients with DES who underwent optical quality and tear film analysis as part of their routine dry eye evaluation pre- and post-neurostimulation trial in office. Optical quality was assessed by measuring the objective scattering index (OSI) and modulation transfer function (MTF). The time to blink and mean tear film OSI were used to analyze the tear film. RESULTS: Optical quality after the use of the intranasal neurostimulator improved with an average decrease (improvement) in OSI of 0.30±0.68 (P=0.015) and an average increase (improvement) in MTF of 2.12±9.2 (P=0.15). Pre-intranasal neurostimulation OSI had a positive correlation with age (Spearman's rho 0.60, p < 0.001), while MTF had a negative correlation (Spearman's rho -0.38, p = 0.03). Pre-intranasal neurostimulation OSI had a negative correlation with MTF (Spearman's rho -0.85, p < 0.001) and a positive correlation with tear film mean OSI (Spearman's rho 0.85, p <0.001). CONCLUSION: The optical quality of patients with DES is improved with the use of intranasal neurostimulation for tear production, and there was a trend towards improved MTF though not statistically significant. Future studies are needed to follow patients longitudinally.

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PURPOSE: The purpose of this study is to evaluate and compare the correlation between changes in vision and HD Analyzer dual-pass metrics versus changes in vision and conventional subjective slit lamp gradings in pseudophakic patients with posterior capsular opacity undergoing neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy. PATIENTS AND METHODS: High contrast (HC) and low contrast (LC) best spectacle-corrected distance visual acuity (BCVA) and HD Analyzer evaluation were prospectively performed on patients with mild-to-moderate posterior capsular opacification (PCO) and monofocal and accommodating intraocular lens implants. Differences between pre- and post-operative measurements were calculated, along with the correlation of HD Analyzer metrics and slit lamp grading to changes in visual acuity. RESULTS: Following Nd:YAG capsulotomy (n=29), there was statistically significant improvement in HC-BCVA and LC-BCVA, decrease in optical scatter, and corresponding improvement in Strehl ratio and HD Analyzer values at all contrast levels tested (p≤0.05). Pearson test showed a high correlation between the improvement in HC-BCVA (r coefficient = 0.78) and LC-BCVA (r coefficient = 0.71) to the improvement in Objective Scatter Index (OSI). There was a higher correlation of change in HC-BCVA to pre-op OSI  (r2=0.61) than to the subjective PCO grading score (r2 = 0.19). There was also a higher correlation of change in LC-BCVA to pre-op OSI (r2 = 0.49) than to subjective grading (r2 = 0.16). CONCLUSION: The HD Analyzer provides objective measurements of forward light scatter (ie, light directed towards the retina) that can assist with both PCO grading and prediction of improvement of visual quality after YAG laser capsulotomy with higher accuracy than conventional slit lamp assessment based upon backscatter (ie, light traveling to the observer) in patients tested with monofocal and accommodating intraocular lens implants.

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PURPOSE: To assess optical quality dynamics using a double-pass (DP) system in patients with dry eye disease (DED). METHODS: Seventy-six eyes with DED and 44 control subjects were enrolled in this study. Each patient underwent ocular surface evaluation including fluorescein corneal staining and Schirmer's II test. Ocular Surface Disease Index (OSDI) questionnaire was used to assess subjective symptoms. Optical quality dynamics and tear film instability was analyzed using a DP system (HD AnalyzerTM, Visiometrics, Spain). Mean objective scatter index (OSI), maximum and minimum OSI, difference between maximum and minimum OSI (ΔOSI) were recorded with 40 consecutive scans over 20 s. RESULTS: The DED group had pronounced impairment of optical quality compared to the control group. Mean OSI (4.29±4.07), minimum (3.22±3.51) and maximum (5.72±4.52) OSI, ΔOSI (2.50±1.96), OSDI score (36.94±16.55), and fluorescein corneal staining (0.79±0.96) were statistically significantly higher than controls (p<0.05). Schirmer's II test was statistically significantly lower in the DED group compared to controls (10.08±7.85, 26.41±6.75, respectively; p<0.001). Three patterns of dynamic changes of OSI were proposed: ladder (continuous increase of OSI), seesaw (instability of OSI without improvement after blinking), and plateau (steady-high OSI). The ladder group showed the highest value of maximum OSI (6.93±4.13; p=0.03) and ΔOSI (3.76±2.08; p<0.001). CONCLUSION: DP imaging system provides an objective measurement of the visual quality in DED. Tear film instability may be assessed by dynamic changes of OSI over 20 s. In particular, the highest OSI values were observed in the ladder pattern group.

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Purpose: To study the correlations between subjective and objective cataract metrics with dysfunctional lens index. To investigate the potential of the DLI as a novel surgery decision-maker. Methods: In this prospective, cross-sectional study, we measured the dysfunctional lens index (DLI), Lens Opacities Classification System III nuclear opalescence (LOCS III NO) grading, preoperative corrected distance visual acuity (CDVA), objective scatter index (OSI) and Scheimpflug-based average lens density (ALD) in eyes with nuclear cataract. Eyes were classified as Surgical and Non-Surgical groups. Correlations among the DLI, OSI, ALD, LOCS III NO grading, and preoperative CDVA were analyzed. The receiver operating characteristic (ROC) curve analysis was performed for DLI, OSI, and CDVA to determine optimal cut-off values to separate between surgical and non-surgical cataracts. Results: The DLI showed the strongest correlation with the OSI (r= -0.712, P< .001), followed by LOCS III NO score (r= -0.661, P< .001), ALD (r= -0.596, P< .001) and preoperative CDVA (r= 0.563, P< .001). The area under ROC curves (AUCs) of the DLI, OSI and preoperative CDVA curve were 0.972, 0.912 and 0.844 (All P< .001), respectively. The DLI cut-off value of 5.7 implied higher levels of sensitivity (91.67%) and specificity (91.84%) than the OSI cut-off value of 2.9 and the CDVA cut-off value of 0.55 (sensitivity of 89.58% and 71.92%; specificity of 81.63% and 85.71%, respectively). Conclusion: The surgery criterion of DLI ≤ 5.7 behaved better than the surgery criterions of OSI ≥ 2.9 and preoperative CDVA ≤ 0.55 in discrimination between surgical and non-surgical nuclear cataracts.

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Objective: To investigate the tear film stability after trabeculectomy and its relationship with bleb morphology using Optical Quality Analysis System Ⅱ (OQAS Ⅱ). Methods: A cross-sectional study. Glaucoma patients undergoing trabeculectomy in the Eye Hospital of Wenzhou Medical University from November 2011 to November 2016 were invited by telephone to perform optical quality, bleb photography, and break-up time examinations, and history of surgeries and medications was collected. Bleb morphology was graded according to the Indiana bleb appearance grading scale. The tear film stability was the average objective scatter index value measured using OQAS Ⅱ for 10 seconds after blinking minus the baseline objective scatter index. The higher the tear film stability value, the worse the stability. The difference in the tear film stability between the surgical eyes and non-surgical eyes was compared by the Mann-Whitney U test, and the relationships between the optical quality, bleb height, extent and vascularity were compared by the Kruskal-Wallis H test. Results: Sixty-three patients (76 eyes) were enrolled in the study, including 55 surgical eyes and 21 non-surgical eyes. The mean follow-up time was (39.6±26.2) months.In the surgical and non-surgical eyes, the M(Q(R)) of tear film stability was 0.46 (0.86) and 0.23 (0.41), respectively. The tear film stability in the surgical eyes was reduced compared to the non-surgical eyes (P=0.044). The trabeculectomy group was divided into three subgroups according to the height of the filtering bleb: H0 (17 eyes), H1 (24 eyes) and H2-3 (14 eyes). The M(Q(R)) of tear film stability in the three subgroups was 0.40(0.68), 0.70(1.02) and 0.40(1.24), respectively, with no statistically significant difference detected (P=0.481). According to the bleb extent, the surgical group was divided into two subgroups: E0-1 (36 eyes) and E2-3 (19 eyes). The M(Q(R)) of optical quality in the two subgroups was 0.63 (0.78) and 0.26(1.17), respectively, with no significant difference detected (P=0.261). According to the degree of bleb vascularity, the surgical group was divided into three subgroups: V0 (25 eyes), V1 (14 eyes), and V2-3 (16 eyes). The M(Q(R)) of optical quality in the three subgroups was 0.39 (0.69), 0.55 (1.18) and 0.63 (1.24), respectively, with no significant difference (P=0.401). Conclusion: Although tear film stability decrease after trabeculectomy, the decrease is not associated with the bleb morphology. (Chin J Ophthalmol, 2019, 55:214-219).

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BACKGROUND: To compare the influence of posterior capsule opacification (PCO) morphology and severity on intraocular stray light and visual function with different levels of contrast. METHODS: Forty-five patients diagnosed with PCO were included in this prospective consecutive case series. The Optical Quality Analysis System II (OQAS II) was adopted to assess the objective visual function including objective scatter index (OSI) and optical quality analysis system values (OVs) with 100, 20, and 9% contrast. RTVue-100 OCT was used to evaluate the PCO morphology and severity. Comparisons among visual function, morphology, and severity between pear type and fibrosis PCO were performed. The correlations among the PCO morphology, severity, OSI, and OVs were also determined. RESULTS: There was a significant correlation between increased OSI and decreased visual acuity in PCO patients before laser capsulotomy. The changes of OSI were also correlated with the PCO area for the 3 mm IOL optic region (r = 0.43, p = 0.02). The OSI was significantly higher in pear type PCO when compared with fibrosis PCO (Z = - 4.06, p ≤ 0.001). In addition, the increased OSI in pear type PCO was significantly correlated with the 100% OVs and the 20% OVs but not with the 9% OVs. In fibrosis PCO, OSI was only correlated with the 100% OVs and the 20% OVs pre-YAG. CONCLUSIONS: OSI and OVs could objectively indicate the visual function impairment in PCO patients. Effects of PCO on light scattering and on objective visual function might be explained by the variations of morphology and severity.

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INTRODUCTION: To report the outcomes in near vision, optical quality and pupil diameter of a new pharmacological therapy (FOV tears) for presbyopia. METHODS: This was a prospective, consecutive, interventional, non-comparative clinical study in which 117 presbyopic patients were given one drop of the novel therapy (FOV tears) in each eye, followed 2 h after the instillation of the eye drop by an evaluation of the binocular uncorrected near visual acuity (UNVA) and uncorrected distance visual acuity. The objective scatter index and pupil diameter under photopic and scotopic conditions before and after instillation were also assessed. The patients were divided into two groups according to their age, with group 1 patients being 41 and 50 years old and group 2 patients, between 51 and 65 years old. RESULTS: The mean age of the patients was 50.2 years. The mean UNVA before the use of the eye drop was 0.35 LogMAR, which improved to 0.16 LogMAR at 2 h after the use of the eye drop (p = 0.000). Nine patients did not show an improvement in UNVA, but no patient showed a loss of lines. Fourteen patients (11.9%) reported headaches as a side effect of the therapy. CONCLUSION: This pharmacological therapy improved near vision by one or more lines (mean improvement 0.18 lines) in 92.3% of the patients at 2 h following the instillation of the eye drops. The group with the youngest patients gained more lines than the group with the oldest patients.

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BACKGROUND: A cataract is a common cause of vision impairment that requires surgery in older subjects. The Optical Quality Analysis System (OQAS, Visiometrics SL, Terrassa, Spain) assesses the optical quality of the eye in cataract patients. This study shows the role of the optical quality evaluation system for decision-making in cataract surgery. We investigated the clinical utility of the OQAS for decision-making in cataract surgery. METHODS: Sixty-seven eyes from 67 patients undergoing cataract surgery and 109 eyes from 109 control subjects were compared. The best corrected visual acuity (BCVA) was measured. The objective scatter index (OSI), modulation transfer function (MTF), Strehl ratio, predicted visual acuity (PVA) 100%, PVA 20%, and PVA 10% were measured using the OQAS. The sensitivity and specificity of the different parameters were analyzed using the receiver operating characteristic (ROC) curve. The main parameters measured were sensitivity and specificity. RESULTS: The BCVA, OSI, PVA 100%, PVA 20%, and PVA 10% were higher in the cataract group compared to those in the control group, while the MTF and Strehl ratios were lower (p <  0.001 for all). ROC analysis showed that the OSI had the largest area under the curve and that the sensitivity and specificity of the OSI were 83.9 and 84.6%, respectively, at the optimal cut-off point of 2.35. CONCLUSION: The MTF, OSI, Strehl ratio, PVA 100%, PVA 20% and PVA 10% may be useful parameters for preoperative decision-making in cataract surgery. The OSI appears to be the most effective parameter for this purpose.

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PURPOSE: To evaluate mesopic visual acuity and visual quality as measured by objective scatter index (OSI) in pseudophakic eyes with long-term follow-up after implantation of hydrophobic acrylic lenses made from two different lens materials. SETTING: This study was carried out in a private clinic. DESIGN: This study was an observational cohort study. METHODS: This pilot study included 181 eyes of 136 patients who had undergone cataract surgery with implantation of monofocal hydrophobic acrylic intraocular lenses (IOLs), either Alcon AcrySof (82 eyes) or Abbott Medical Optics' Tecnis (99 eyes). The monocular corrected distance visual acuity (CDVA) of the subjects was recorded under mesopic room illumination and OSI was measured by an optical quality analysis system using double-pass wavefront method. RESULTS: Mean follow-up duration was 60.07±18.82 months. Eyes implanted with Tecnis IOLs had statistically significantly better mesopic CDVA (0.08±0.08) compared to those implanted with AcrySof IOLs (0.11±0.07) (P=0.020). Mesopic CDVA of 20/25 or better was found in 79.8% of eyes in the Tecnis group compared to 62.2% of eyes in AcrySof group. Similarly, OSI was also found to be statistically significantly better for Tecnis IOLs compared to AcrySof IOL group (mean OSI, Tecnis: 1.65±0.92, AcrySof: 2.01±1.36; P=0.033). When glaucomatous eyes were excluded, OSI was still significantly better (P=0.028) in the Tecnis IOL group. CONCLUSION: The eyes implanted with Tecnis IOLs showed better long-term optical performance in terms of both OSI and mesopic visual acuity in comparison to those with AcrySof IOLs.