Light scattering and optical aberrations as objective parameters to predict visual deterioration in eyes with cataracts

Purpose: To predict the visual deterioration of eyes with cortical (CC) or nuclear (NC) cataract from objective data on ocular higher-order aberration (HOA) and forward (FLS) and backward light scattering (BLS). Setting: Osaka University Medical School, Osaka, Japan. Methods: Twenty-two eyes with mild NC, 41 eyes with mild CC, and 11 normal eyes were examined. Higher-order aberrations were calculated with the Zernike polynomials up to the fourth order from the values obtained by wavefront analysis using the Hartmann-Shack aberrometer. Forward light scattering was calculated from the size of the aberrometer spot images for the central 4 mm, and backward light scattering (BLS) was calculated from the optical density of the Scheimpflug images. The relationship between the area under the log contrast sensitivity function (AULCSF) curve and HOAs, FLS, and BLS was examined. Results: Area under the log contrast sensitivity function was moderately correlated with the HOAs, FLS, and BLS. Multiple linear regression analysis revealed that the AULCSF was predicted by the linear combination of these variables (R-2=.484, P<.001). Area under the log contrast sensitivity was predicted by BLS and HOA (R-2=.555) in the NC group and by FLS and HOAs (R-2=.540) in the CC group. Conclusions: Loss of contrast sensitivity was predominantly due to BLS and HOA in eyes with NC and FLS and HOA in eyes with CC. Higher-order aberrations, FLS, and BLS, variables that are obtained objectively, can be used to predict quantitatively the visual deterioration in cataractous eyes.