Patients who received cataract surgery noted improvement in photophobia post-op. Photo: Joseph Sowka, OD. Click image to enlarge.

No study has analyzed the alteration in photophobia before and after cataract surgery or the association between retinal spatial property and photophobia up until this point. Researchers recently determined that the spatial properties of retinal imaging modified by higher-order aberrations (HOAs) may affect the degree of photophobia. Scattering light due to cataracts could contribute to photophobia more than HOAs, which may mask the effect of HOAs for photophobia preoperatively.

The study investigated 71 eyes of 71 patients who received conventional cataract surgery. The team measured the HOAs of the entire eye and the subjective photophobia score. A score of zero was assigned to the absence of photophobia and 10 to the presence of severe photophobia that prevented eye opening. The study classified patients into two groups: photophobia unconcerned included patients who selected zero preoperatively or postoperatively and photophobia concerned included the remaining patients.

After cataract surgery, photophobia scores increased, remained unchanged (stable) and decreased in three, 41 and 27 cases, respectively. In the stable group, 85.4% of cases belonged to photophobia unconcerned. In photophobia concerned, there were significant correlations between photophobia score and postoperative root-mean-square values of total HOAs (Spearman’s rank sum correlation (rs) = 0.52), total coma (rs = 0.52), total trefoil (rs = 0.47) and third-order group (rs = 0.53). In contrast, there was no significant correlation between photophobia scores and preoperative HOAs.

The results showed that approximately half of the patients who required cataract surgery did not experience any subjective photophobia before or after surgery. Contrastingly, among the patients who reported photophobia before surgery, three-quarters reported improvement in subjective photophobia after surgery.

“Our data indicated that HOAs induced by the cornea and intraocular lenses may explain part of the subjective postoperative photophobia,” the researchers concluded in their paper.

Ishiguro N, Horiguchi H, Katagiri S, et al. Correlation between higher-order aberration and photophobia after cataract surgery. PLoS One. 2022;17(9):e0274705.