Retinal straylight before and after implantation of the Bag in the Lens IOL

To quantify the changes in retinal straylight that occur after implantation of the Bag in the Lens (BIL) IOL, which by design avoids the formation of posterior capsule opacification or any influence of the posterior lens capsule.

This prospective study included 81 eyes of 53 cataract patients planned for surgery with the BIL. Preoperatively and 6 months postoperatively their straylight level was determined using the compensation comparison method.

After implantation of the BIL straylight significantly improved from 1.59 ± 0.26 preoperatively to 1.19 ± 0.21 log units postoperatively (paired t-test, P < 0.001). Postoperative straylight was within age-normal levels in 56.1% of the eyes and went below age-normal values in 40.2% of the eyes. Average postoperative straylight remained 0.27 log units (or 1.87×) above the age-independent base straylight value of 0.931 + 0.200. Postoperatively straylight was not significantly correlated with age (r(2) = 0.001), but it was significantly correlated with a regression model that combines both age and axial length (r(2) = 0.199).

Retinal straylight after implantation of the BIL is comparable to what has been published for the early follow-up of other IOL types, suggesting that a clear posterior lens capsule does not seem to add to straylight. However, for all IOL types average postoperative straylight remains above the expected base level, possible due to nonlenticular age-related parameters or to the physiological response of the ocular tissues to the surgical act. This should be examined in further detail in future studies.