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Understanding causes of ring-shaped dysphotopsia associated with posterior chamber phakic implantable collamer lenses with a central hole

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Session Details

Session Title: Phakic IOLs II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 15:09

Venue: Room 17

First Author: : H.Kim SOUTH KOREA

Co Author(s): :    Y. Eom   D. Kim   D. Ryu   S. Yang   J. Song   S. Kim     

Abstract Details


The aim of this study was to compare the vision quality of posterior chamber phakic implantable collamer lenses (ICLs) with and without a central hole (i.e. conventional vs. Hole ICL) and to determine the causes of central hole-induced dysphotopsia.


Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea, College of Optical Sciences, University of Arizona, Tucson, AZ, USA, Space Optics Laboratory, Department of Astronomy, Yonsei University, Seoul, South Korea


Non-sequential ray tracing was used to construct a myopic human eye model with conventional and hole ICLs. Simulated retinal images measured in log-scale irradiance were compared between the two ICLs for an extended Lambertian light-emitting disk object 20 cm in diameter placed 2 m away from the corneal vertex. To investigate the causes of hole-induced dysphotopsia, a series of retinal images were simulated using point sources at infinity with well-defined field angles (0 to -20º) and multiple ICL models with varying ICL thickness and radius of curvature of the hole edge.


From the case study using an extended Lambertian source, hole ICL-evoked ring-shaped dysphotopsia was formed at a retinal field angle of ± 40º. Component level analysis using a well-defined off-axis point source from infinity revealed various hole-induced stray light patterns in addition to the nominal point spread image on the retina. Ring-shaped dysphotopsia was generated by stray light refraction from the inner wall of the hole and the posterior ICL surface. Hole-induced ring-shaped dysphotopsia was successfully simulated and the mechanism of development was established.


Hole ICL-evoked ring-shaped dysphotopsia was related to light refraction at the central hole structure. Surgeons should explain to patients the possibility of glare and ring-shaped dysphotopsia after Hole ICL implantation.

Financial Interest:


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