Study of Visual Quality and Higher Order Aberrations in Early Posterior Capsular Opacification

Purpose: This study aims to explore the visual quality and characteristics of higher order aberrations (HOAs) in patients with early posterior capsule opacification (PCO), providing a theoretical basis for the clinical assessment of early PCO and the potential benefits of Nd:YAG posterior capsulotomy. Methods: This cross-section observational study included 73 patients (73 eyes) diagnosed as PCO at a tertiary hospital from September 2022 to September 2023. All subjects underwent optometric examinations, OQAS, and iTrace measurements, followed by posterior capsule retroillumination photography after full mydriasis. Images were imported into ImageJ software, selecting a 3-mm diameter central area of the intraocular lens (IOL), and the mean gray value (MGV) of this area was recorded. Statistical analyses were conducted on baseline data, the first PCO follow-up time, logMAR corrected distance visual acuity (CDVA), MGV, objective visual quality parameters, dysfunctional lens index (DLI), and various HOAs parameters. Results: Compared to the control group, the PCO group exhibited statistically significant differences in parameters such as OSI, MTF cutoff, SR, trefoil, Z18, and Z24 (p < 0.05); however, logMAR CDVA, HOs total, coma, and spherical aberration did not show significant differences (p > 0.05). Compared to the monofocal IOL (MoIOL) group, the multifocal IOL (MfIOL) group had earlier PCO follow-ups, with significantly better MTF cutoff and SR, and significantly lower Z7 and Z10 (p < 0.05). Subgroup analysis based on OSI showed significant differences between the two groups in parameters such as logMAR CDVA, MTF cutoff, SR, DLI, HOs total, and coma (p < 0.05). Conclusions: Early PCO significantly impacts objective visual quality and HOAs in patients. Early intervention may provide greater visual benefits for patients implanted with MfIOL.