Photic phenomena after phacoemulsification: comparison of two different intraocular lenses

Poster Details

First Author: S.Masnec Oluji? CROATIA

Co Author(s):    M. Kalauz   R. Kordi?   T. Kuzman   B. Cerovski     

Abstract Details

Purpose:

To determine the incidence of dysphotopsia after phacoemulsification and the relationship between Akreos Adapt AO (Bausch&Lomb) and Acrysof IQ (Alcon) intraocular lens (IOL) types.

Setting:

University Hospital Center Zagreb, Department of Ophthalmology, Zagreb, Croatia

Methods:

Prospective study included 153 patients over a 12-month period of recruitment, from September 2010 till September 2011. Only patients with well-centered IOL s, visual acuity better then 0.5, IOL power calculation for emetropia 20.0-25.0 D, astigmatism ?1.5 D, pupilar diameter ? 4 mm in mesopic conditions and the absence of concomitant ocular co-morbidity were included in the study. They were excluded if they had refractive errors which could cause similar phenomena. All patients signed written informed consent. Phacoemulsification was performed in all patients, by the same surgeon using superior clear corneal incision. Patients filled up a written questionnaire that graded symptoms of positive and negative dysphotopsia and reported on incidence of unwanted images, glare and light sensitivity. Follow up was after one week and after eight weeks. For statistical analysis chi square test was used.

Results:

The Akreos Adapt AO IOL was implanted in 78 patients and Acrysof IQ in 75 patients (71 right eyes, 82 left eyes), 90 were women and 63 men, age 61,2±7,3. After 1 week follow-up period significant number of patients reported symptoms in group of patients with Acrysof IQ intraocular lens. The difference between groups was statistically significant (p<0.05). No patient in the Akreos group and 5 patients (6,66%) in the Acrysof group described symptoms of negative dysphotopsia. Eight weeks postoperatively , the between-group difference was not significant. No patient in the Akreos group and 3 patients (4%) in the Acrysof group described symptoms of negative dysphotopsia. Patients reporting this phenomenon were satisfied with the surgical outcome and therefore no intraocular lens exchange was needed.

Conclusions:

Our data indicate that after cataract surgery early symptoms of negative dysphotopsia depend on IOL type and that the Akreos Adapt AO intraocular lens appears to be superior to the Acrysof IQ in this regard. Beyond several weeks, process of neuroadaptation seems to play a great role and negative dysphotopic complaints rarely persists. More work with a larger series is required that might help to uncover the mechanism of negative dysphotopsia. FINANCIAL DISCLOSURE?: No