Dysphotopsia in phakic and pseudophakic patients: Incidence and relation to intraocular lens type

Purpose: To determine the relationship between various intraocular lens (IO L) types and the incidence of unwanted light images. Setting: The Moran Eye Center, University of Utah, Salt Lake City, Utah, US A. Methods: A telephone questionnaire was administered to 302 postoperative pa tients who had received 1 of 6 commonly used IOLs between January and Septe mber 1998. Patients were included only if they had uneventful cataract surg ery, no additional ocular pathology, and a postoperative best corrected vis ual acuity of 20/25 or better, A control group of 50 patients with the diag nosis of presbyopia only also participated in the questionnaire. Patients r eported on incidence of glare, light sensitivity, and unwanted images. The data were analyzed for statistically significant relationships between inci dence of photopsias and IOL type. Results: The AcrySof 5.5 mm, AcrySof 6.0 mm, and SI-40 groups reported sign ificantly more unwanted images than the control group (P = .0014). The 2 Ac rySof groups also reported a greater incidence of light to the side causing a central flash, and the SI-40 group, a higher incidence of glare. The con trol group was more likely to experience symptoms of glare than any pseudop hakic group. Overall, a mean of 49% of patients reported some light-related phenomenon postoperatively. The majority in all groups reported being sati sfied with their eyesight despite the light-related problems. Conclusions: A significant number of pseudophakic patients reported symptom s of dysphotopsia. Patients who received an acrylic IOL with flattened edge s were at increased risk of experiencing images associated with edge reflec tions. The SI-40 lens group, although less than the AcrySof groups, reporte d a higher incidence of glare than the non-AcrySof groups; however, it also had the highest number of patients still driving at night. The phakic popu lation commonly experienced glare reported as more severe than several of t he IOL groups. (C) 2000 ASCRS and ESCRS.