Optical Properties Influence Visual Cortical Functional Resolution After Cataract Surgery and Both Dissociate From Subjectively Perceived Quality of Vision

Purpose: To investigate the relation between optical properties, population receptive fields (pRFs), visual function, and subjectively perceived quality of vision after cataract surgery.

Methods: The study includes 30 patients who had recently undergone bilateral sequential cataract surgery. We used functional magnetic resonance imaging and pRF modelling methods to assess pRF sizes across visual cortical regions (V1-V3). Subjects also performed a complete ophthalmologic and psychophysical examination and answered a quality of vision questionnaire.

Results: Subjects with worse optical properties had, as predicted, larger pRF sizes. In addition, analysis in the primary visual cortex revealed significantly larger mean pRF sizes for operated subjects with worse contrast sensitivity (P = 0.038). In contrast, patients who scored high in the subjective "bothersome" dimension induced by dysphotic symptoms had surprisingly lower pRF size fitting interception (P = 0.012) and pRF size fitting slopes (P = 0.020), suggesting a dissociation between objective quality of vision and subjective appraisal.

Conclusions: Optical properties of the eye influence pRF size. In particular, visual aberrations have a negative impact on visual cortical processing. A novel dissociation between subjective reports of quality of vision and pRF sizes was further identified. This suggests that patients with better cortical resolution may have a negative subjective response possibly because of improved perception of dysphotic phenomena. pRF properties represent a valuable quantitative measure to objectively evaluate quality of vision but do not necessarily predict subjective complaints.