ESCRS - FP01.10 - GLARE, STARBURSTS AND DYSPHOTOPSIAS IN NIGHT DRIVING WITH DIFFERENT TYPES OF IOLS: A LABORATORY STUDY

GLARE, STARBURSTS AND DYSPHOTOPSIAS IN NIGHT DRIVING WITH DIFFERENT TYPES OF IOLS: A LABORATORY STUDY

Published 2025 - 29th ESCRS Winter Meeting

Reference: FP01.10 | Type: Free Paper | DOI: 10.82333/q63t-9f19

Authors: Harilaos Ginis* 1 , Dimitrios Christaras 1 , Spyridon Tsoukalas 1 , Jose Maria Marin 2 , Pablo Artal 3

1diestia,Athens,Greece, 2Oftalvist,Murcia,Spain, 3Laboratorio de Optica, Universidad de Murcia,Murcia,Spain

Purpose

We employed a physical model eye in combination with three different types of intraocular lenses and a moving glare source to visualize and analyze entoptic phenomena in the mid and far periphery simulating driving conditions.

Setting

Laboratory testing, Diestia Systems, Athens Greece

Methods

We employed a water-filled eye model had a PMMA cornea with a radius of 7.73mm (Q= -0.18) and an iris at 3.55mm from the anterior surface of the cornea. Each IOL was positioned at a plane 1mm behind from the pupil (ACD of 4.45mm). Pupil diameter was 5mm to mimic the mesopic / scotopic conditions of night driving. Images (videos) of a bright point source moving at the peripheral visual field (30-70 degrees) were recorded at the retinal plane using a camera in a water-tight enclosure. Entoptic phenomena (glares, halos, dysphotopsias) were evaluated for three types of IOLs: biconvex (AcrySof IQ PanOptix (Alcon, TX, USA), TECNIS Eyhance (Johnson&Johnson, USA)) and inverted meniscus (ArtIOL Art40 (Voptica SL, Murcia, Spain)).

 

Results

A characteristic meniscus-image pertaining to the light passing around the IOL’s optic was observed in all lenses having increased intensity for larger field angles. We superimposed the recorded images to a rural road night image to simulated the impact of these phenomena in night driving. The biconvex lenses had a very bright meniscus, exceeding the primary light for angles greater that 60 degrees. This phenomenon creates the impression that opposing traffic is moving faster than normal when at the periphery of the visual field. The inverted meniscus IOL (Art40) did not exhibit this meniscus presumably due to its shape that allows a narrower gap between the posterior iris and the IOL edge.

Conclusion

The intensifying meniscus appearing at the periphery of the visual field as field angle increases after cataract surgery may lead to an overestimation of the speed of vehicles in the periphery during night driving. Inverted meniscus IOLs tend to reduce this effect. The possible implication of this phenomenon in patient’s safety may require further investigations.