Quantifying glare phenomena in patients with different intraocular lenses using a standard and modified clinical straylight meter

PURPOSE: To assess if differences in straylight can be detected in patients implanted with multifocal intraocular lenses (IOL) using a standard and modified clinical straylight measurement.

SETTING: A tertiary care university eye clinic.

DESIGN: Comparative cross-sectional study.

METHODS: Straylight was measured at 7 and 2.5 degrees using the standard and modified C-Quant (Oculus Optikgeräte) devices. Two measurements per eye and angle were obtained. Logarithm of the straylight parameter (s) at both angles and its increase between 7 and 2.5 degrees were compared between study groups.

RESULTS: Thirty-eight patients (67 eyes) were included in total: 12 patients (24 eyes) implanted with Tecnis Synergy (Johnson & Johnson Vision), 13 patients (25 eyes) with Clareon PanOptix (Alcon), and 13 patients (18 eyes) with monofocal lenses. The mean (±standard deviation) straylight values at 7 degrees were 0.98±0.16 log(s) with Synergy, 1.03±0.14 log(s) with PanOptix, and 1.05±0.22 log(s) with monofocal controls (p=0.864). At 2.5 degrees, they were 1.55±0.09 log(s) with Synergy, 1.34±0.10 log(s) with PanOptix, and 1.29±0.21 log(s) with monofocal IOLs (p<0.001). The increase in straylight at 2.5 degrees was 0.57±0.13 log(s) for Synergy, 0.31±0.11 log(s) for PanOptix, and 0.25±0.10 log(s) for monofocal controls (p<0.001).

CONCLUSIONS: Straylight measurements at 2.5 degrees using the modified technique showed higher straylight levels with Synergy when compared to PanOptix and monofocal IOLs, while the standard technique did not detect differences between IOLs. Straylight testing at smaller angles emerges as a sensitive measure to identify multifocal designs posing an increased risk of inducing photic phenomena in pseudophakic patients.