Epidemiology and intervention for dysphotopsia

Positive dysphotopsias less common than negative but cause more disturbing symptoms

Cheryl Guttman Krader

Posted: Sunday, September 15, 2019

Nick Mamalis

Dysphotopsias may be one of the most significant factors for patients having a negative outcome after uncomplicated cataract surgery.

Speaking at the clinical research symposium on “Understanding and Dealing With Dysphotopsias”, Nick Mamalis MD discussed the epidemiology of positive and negative dysphotopsias.

Positive dysphotopsias are less common than negative dysphotopsias, but they cause more disturbing symptoms. The aetiology appears to be related to IOL material, particularly hydrophobic acrylic and a square-edge design. Therefore, IOL exchange using an implant made of a different material is often immediately effective for resolving dysphotopsias, said Dr Mamalis, Professor of Ophthalmology, John A. Moran Eye Center, Salt Lake City, Utah, USA.

Negative dysphotopsias are likely also related to IOL material and design, but space between the iris and the IOL surface and the relationship of the anterior edge of the capsulotomy may also be contributing factors. Treatment may involve placement of an IOL in the ciliary sulcus or of an add-on IOL as well as reverse-optic capture of the existing IOL.

“However, negative dysphotopsias are more likely than positive dysphotopsias to resolve spontaneously. Therefore, when patients complain about this problem, surgeons should not rush to try to do something about it,” said Dr Mamalis.