Dysphotopsias with aspherical foldable Acrysof SN60WF intraocular lens A preliminary report

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Dysphotopsias with aspherical foldable (Acrysof
SN60WF) intraocular lens A preliminary report

• Charith Fonseka
• Colombo Eye Hospital
• Sri Lanka

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Introduction

• Dysphotopsias are unwanted visual sensations and
  can cause patient dissatisfaction after otherwise
  successful cataract surgery
• They have been attributed predominantly to edge
  design and the high refractive index of IOLs

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Purpose

• A preliminary report of a prospective study of
  Dysphotopsias, following implantation of an
  Acrysof SN60WF IOL in 760 consecutive adult eyes
  after standard phacoemulsification.
• Assess the incidence
• Assess any associated factors with
• positive Dysphotopsias
• negative Dysphotopsias

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Population

• Sri Lanka is a south Asian country with a highly
  literate population
• Ambient night time lighting (indoor and outdoor)
  is much less than in countries of the western
  hemisphere

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Methods

• Data of 280 of the 760 consecutive adult eyes
  scheduled for standard microcoxial (2.2mm)
  phacoemulsification with an Alcon infinity system
  (torsional) with implantation of an Acrysof
  SN60WF IOL were included.
• Exclusion criteria
• Eyes with copathology
• per or post operative complications were
  excluded.

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Methods - Data collected

• Age gender and laterality
• IOL power, pre op K readings, axial length
  measurement of white to white diameter and
  anterior chamber depth.
• First or second eye
• Occupation, leisure activities, and hobbies and
  driving.
• Second post operative visit (mean 36.4 days post
  op)

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• Post op K values, surgical astigmatism anterior
  chamber depth and refraction were assessed.
• Complaints about quality of vision if volunteered
  were recorded.
• Questioned about presence of dysphotopsias
• positive (shimmering or pulsating light, arc,
  flare, central flash or haloes)
• negative (temporal darkness)
• All patients who complained are being telephone
  interviewed at 3 months post surgery to determine
  the status of dysphotopsias.

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Results
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Results
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Results

• Types of positive dysphotopsias
• arcs of light 9
• Central flashes 3
• Ghost images or shadows 2
• Types of negative dysphotopsias
• Temporal darkness 2
• Sense of lateral part of upper lid not completely
  opening 3

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Results

• Statistical analysis did not show any association
  of Anterior chamber depth, lens power, laterality
  with dysphotopsias
• Total percentage with dysphotopsias 6.7
• Volunteered dysphotopsias 3.5
• Positive dysphotopsias 5
• Negative dysphotopsias 1.7

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Conclusions

• Dysphotopsias tend to be low in Sri Lankan
  patients undergoing implantation with Acrysof
  aspherical IOLs.
• Severe dysphotopsia is almost never seen