Hyperosmolar patients significantly increased variation in light scatter following cataract surgery: Study
Tear film hyperosmolarity acts as a potent cellular stress on the ocular surface that can induce epithelial cell death and compromise the barrier functions of the cornea. Hyperosmolarity has been shown to be associated with significant (>1.0 diopter (D)) test-to-test variations in the measured corneal astigmatism and >0.5 D variations in IOL power, adding noise that functionally limits the resolution of keratometry and increases the likelihood of unexpected refractive error after cataract surgery.
Although prior research has shown that tear film hyperosmolarity can compromise pre-surgical measurements and impact post-surgical outcomes, it is not currently known whether hyperosmolarity is directly associated with aberrant visual sequelae. Therefore, author’s current hypothesis was that hyperosmolarity is associated with increased variation in light scatter between blinks, and specifically, that this effect is not observable under a slit lamp. If this hypothesis is correct, it would likely help to explain a portion of the phenomenon of a post-operative patient that achieves target refraction, hasan unremarkable ocular surface, but is dissatisfied with the overall quality of vision – colloquially known as the 20/20 unhappy patient.
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