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Comparison of Photopic and Mesopic Contrast Sensitivity and Glare Disability in Patients with Acrylic, Silicone, Hydrogel and PMMA Intraocular Lenses and in Phakic Controls

1Schmitz K., 1Lindner H., 2Röhl F.-W., 1Behrens-Baumann W.,
1Otto-von-Guericke-Universität Magdeburg, Universitäts-Augenklinik (Magdeburg)
2Universität Magdeburg, Institut für Biometrie (Magdeburg)

Purpose: To apply different psychophysical tests to compare contrast sensitivity and glare disability both under photopic and mesopic conditions in patients with cataract and after implantation of intraocular lenses (IOLs) of different materials.
Methods: Of 99 eyes with no ocular pathology than cataract, 79 randomly received intraocular lenses of different materials after uneventful surgery: 20 eyes received hydrophobic acrylic IOLs, 20 silicone IOLs, 20 hydrogel IOLs, and 19 eyes received polymethyl methacrylate (PMMA) IOLs. All patients were evaluated using 10 psychophysical function tests in the low-vision laboratory of the University-Eye-Hospital at three to six months postoperatively. Another 20 age-matched patients with only little cataract progression served as phakic controls undergoing the same series of tests.
Results: All patients showed good visual acuity and good photopic contrast sensitivity postoperatively. The results for all tests were worse under mesopic conditions and in the presence of glare sources. Differences between the IOL groups were only marginal in all test settings and reached statistical significance only under very few test specifications. The postoperative patients performed better than the phakic controls in all test subgroups except for glare disability under mesopic conditions.
Conclusions: All tested IOL materials delivered a comparable performance in all applied psychophysical visual function tests. Performance was better under photopic conditions. Future investigations in context with the renewed interest on IOL optic design (sharp edge, edge surface properties) will show, if the problem of poorer performance under mesopic conditions can be overcome.