Getting clean FAF through cataract

But i’m struggling to get usable 488 nm FAF on a Spectralis through 2+ NS; dropping to a 30° field and averaging ART 50 tightens the signal, but the image still looks muddy versus 55° with ART 9. Any tweaks to detector sensitivity or focus offset that help, or is this where you switch patients to UWF FAF on Optos to support the diagnosis?

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help, or is this where you switch patients to UWF FAF on Optos to support the I’ve had better luck on Spectralis by setting IR focus, then nudging FAF focus +1–2 D anterior and dropping to ART about 20–25 while inching sensitivity up to just before speckle; if it’s still flat, I’ll try NIR‑FAF before sending to Optos. Are you focusing on live FAF or staying locked to IR?

My take: I’d lean toward the simplest next step and see if it changes anything this week — if not, you’ve got a clear case to escalate. What would block you from trying that?

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, through 2+ NS I’ve had better luck staying at 55° and nudging laser power up 1–2 clicks while backing detector sensitivity down so the histogram sits just under clipping; once ART creeps past about 20–25 it just averages the haze… If it’s still muddy, I’ll grab NIR-AF on the Spectralis to support the RPE call before sending to Optos UWF unless I really need the periphery. @lhamilton33 have you seen the same gain vs illumination tradeoff?

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