Dysphotopsia after Cataract Surgery: Comparison of Four Different Intraocular Lenses

Abstract

Aim: To assess the risk of dysphotopsia after phacoemulsification, with the use of four different intraocular lens (IOL) models. Methods: In this prospective randomized study, 600 patients underwent phacoemulsification surgery. Four study groups were formed, according to the type of the IOL implanted: Meridian HP60M [Bausch & Lomb, hydrogel, 6 mm, three piece (3P), square edge, refraction index (RI): 1.470], Acrysof MA60BM (Alcon, acrylic, 6 mm, 3P, square edge, RI: 1.550), Acrysof MA30BA (Alcon, acrylic, 5.5 mm, 3P, square edge, RI: 1.550) and Clariflex (AMO, silicone, 6 mm, 3P, anterior round and posterior square edge, RI: 1.460). Patients were examined for dysphotopsia symptoms after 1 week, 1, 3 and 6 months. Results: During the first follow-up visit, 117 patients (19.5%) reported dysphotopsia. During the next visits, the actual number of patients still reporting phenomena declined. Optic phenomena occurred less frequently in patients with AMO Clariflex lens, especially when compared to Acrysof (5.5 and 6 mm); IOL odds ratios ranged from 2.27 to 6.7, depending on follow-up time (p value < 0.05). IOL optic diameter was negatively but significantly associated with the risk of dysphotopsia. Conclusions: The design of the optic edge and the optic diameter of the IOL play an important role in the occurrence of dysphotopsia. AMO Clariflex, with round anterior and square posterior edge, overcomes the problem of dysphotopsia to a considerable extent.

Stability of a Novel Intraocular Lens Design: Comparison of Two Trifocal Lenses

“…1,11,24 Moreover, it has been claimed that such phenomena are more prevalent with hydrophobic IOLs. 25,26 In our study, patients were specifically questioned about photic phenomena and halometry was employed. For both investigations, although the differences were slight, the objective and subjective data showed better values in the FineVision/MicroF lens group.…”

Effect of interface reflection in pseudophakic eyes with an additional refractive intraocular lens

“…Bournas et al 20 also found a reduction over time in the percentage of patients with postoperative dysphotopsia, which was obviously a result of neural adaptation.…”

Dysphotopsia-Unraveling the Enigma

“…Holladay et al theorized that higher incidence of ND with acrylic IOLs was because of such higher distance (0.06-1.2 mm for acrylic vs 0.06 mm-0.62 mm for silicon foldable IOL). 5 Secondary factors can be high μ of optic material (lower μ of silicone compared with acrylic moves the anterior and the posterior border of shadow forward reducing the width of the shadow from 14.0 0 for acrylic to 2.3 0 for silicone), increased angle α (that causes the eye to turn temporally leading to the formation of ND because of the increased exposure of the nasal retina), nasal location of the pupil relative to the eye's optical axis (if the pupil was displaced nasally by 2.6 0 (0.3 mm on the cornea), the pupil would be closer to the nasal edge of the IOL 8,5 again exposing more of the nasal retina), transparent vs translucent status of the peripheral nasal capsule, high plus lenses, idiosyncratic predisposition 21 , cataract incision located temporally in clear cornea 14 , brown irides…”

“…According to Bournas et al,19.5% of cataract patients complained of dysphotopsia on the first postoperative day. 14 Osher reported symptoms of ND on the first postoperative day in 15.2% of patients that decreased to 3.2%, one year after surgery.…”