INCIDENCE OF NEGATIVE DYSPHOTOPSIA AMONGST PSEUDOPHAKES: A PROSPECTIVE SURVEY STUDY

Negative dysphotopsia (ND) is an optical phenomenon described as a dark arc-like peripheral temporal shadow; which continues to be a primary source of dissatisfaction following uncomplicated phacoemulsification. Globally, several studies report the incidence of ND ranging from 0.2-20%. In the first of its own, we report the incidence of ND in a large NHS Trust.

In this prospective survey study, adult patients under two surgeons were recruited from July ’22 to October ’22 from two hospital sites New Cross Hospital and Cannock Chase Hospital within the Royal Wolverhampton NHS trust, UK. 

All patients had phacoemulsification with intraocular enVista or EyeCee One (Bausch and Lomb) hydrophobic lens implantation. Following consent, patients were interviewed by telephone post-operatively at 6-10 days using a validated questionnaire. The protocol was later amended to interviews at 3-5 days due to survey results and in order to minimise recall bias. Outcomes included symptom onset, duration of symptoms and a quantitative bothersome rating out of 10. Patients with unresolved ND were re-interviewed at 28 days in order to monitor ND resolution. Routine follow-up and safety netting was also performed.

Of 102 patients contacted day 6-10 post-op, 80 responded (78.4%). 6 of 80 (7.5%) reported ND, of which 3 (50.0%) had onset from Day 0 and 3 (50.0%) by Day 1. Mean bothersome rating was 3.5 ± 2.26 of 10. 5 of the 6 patients had resolution by day 6-10, with mean duration of 2.2 ± 0.87 days. 1 patient had ongoing ND in this cohort. Due to acute ND onset and in order to minimise recall bias, 80 further patients were contacted day 3-5 post-op of which 54 (67.5%) responded. 3 of 54 (5.6%) patients reported ND, of which 2 (66.7%) had onset from Day 0 and 1 (33.3%) by Day 2. Mean bothersome rating was 4 ± 3.46 of 10. 2 of 3 patients had complete resolution by day 3-5, with mean duration of ND 1.5 ± 2.12 days. 1 further patient surveyed in this cohort had ongoing ND.

ND incidence was 6.7% between both cohorts which is comparable to previously published data, of which the majority (77.8%) were transient and minimally bothersome. There was no statistical significance between interviewing patients earlier at 3-5 days vs. 6-10 days. A larger study is recommended to better understand patients with ongoing ND.