Negative dysphotopsia incidence, management and outcome

Session Details

Session Title: Combined Cataract Surgery Techniques. Surgical Devices

Session Date/Time: Saturday 05/09/2015 | 08:30-10:30

Paper Time: 09:35

Venue: Main Auditorium

First Author: : J.Laursen DENMARK

Co Author(s): :    J. Pedersen   K. Næser                 

Abstract Details

Purpose:

To establish the incidence of negative dysphotopsia and to describe the management hereof in terms of various treatments and preventive measures.

Setting:

Randers Eye Clinic, Randers Region Hospital, Denmark.

Methods:

The standard IOL in this clinic is the AMO Tecnis 1-piece IOL with sharp posterior edges. In case of negative dysphotopsia in the first operated eye, an AMO 3-piece IOL is placed in the sulcus in the second eye as a preventive measure. We reviewed the electronic medical records of all patients operated in 2012-2014. Medical records of all patients not receiving the standard IOL were studied and patients complaining of negative dysphotopsia were identified. All surgeries in these eyes were uncomplicated with proper in the bag placement of the IOL. Both temporal and superior corneal incisions were used.

Results:

Twelve symptomatic eyes were identified in 11 out of 2795 operated patients (0.4%). Five eyes underwent secondary surgery, while 7 eyes were treated conservatively. Among the operated eyes one received a piggy-bag IOL, which did not relieve symptoms. One had the IOL replaced with an anterior chamber lens and in three eyes the IOL was replaced by the 3-piece in the sulcus all four eyes enjoyed complete resolution of symptoms. In the conservatively managed group two became asymptomatic, 1 reported decreased symptoms and 4 remained symptomatic after 6 weeks. None of the nine fellow-eyes with sulcus placed IOLs developed symptoms.

Conclusions:

Severe negative dysphotopsia requiring surgery is rare (0,2%). In the conservatively managed group symptoms resolved in 3/7 patients. Replacing an in the bag IOL with an IOL in the sulcus immediately resolves symptoms of negative dysphotopsia. This approach also works as a preventive measure.

Financial Interest:

NONE