Standardized digital imaging technique aims to increase understanding of intralenticular glistenings

Researchers developing a method for standardized digital photographic analysis ofintralenticular glistenings believe it represents an important step forward in the scientificassessment of this IOL complication and its visual significance. William Trattler, MD,described the work that has been done to develop protocols for capturing images of themicrovacuoles under standardized conditions in order to maximize visibility of themicrovacuoles and enhance the utility of the images obtained.

The studies have involved patients implanted with an acrylic IOL who have clinically documentedintralenticular glistenings, said Dr. Trattler, a private practitioner in Miami, and volunteerassistant professor, Bascom Palmer Eye Institute, University of Miami.

Parameters considered included angle of illumination, slit lamp magnification, slit size, areaof focus, camera type, and resolution. The investigators also developed a grading system wherethe severity of the glistenings are scored using digital image processing software that takesinto account the number and size of the microvacuoles in a central 2- × 2-mmregion.

"We are all familiar with glistenings in IOL material," Dr. Trattler said. "However, theirprevalence, severity, and visual significance with respect to effects on visual acuity,contrast sensitivity, and/or dysphotopsias remain controversial because no consistent standardexists for the in vivo evaluation or photographic capture of these microvacuoles.

"We believe glistenings represent an important biomaterial issue that should be considered inIOL selection," he said. "Through the use of standardized imaging techniques and grading scalesand the undertaking of a full scale study, we hope to be able to better assess them andunderstand how they impact vision."