The Influence Of Intraocular Monofocal Lens Orientation On The Occurrence Of Positive And Negative Dysphotopsia
Published 2025 - 43rd Congress of the ESCRS
Reference: PP01.13 | Type: Poster | DOI: 10.82333/vnch-2397
Authors: Suzana Matić* 1 , Lucija Matic 2 , Ivana Strunje 1 , Marija Jelic Vukovic 1 , Mate Matic 3 , Vedran Nemet 1 , Marija Matic 4 , Tvrtka Benasic 1
1Department of Ophthalmology and Optometry,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek,Osijek,Croatia;Department of Ophthalmology, Osijek University Hospital Centre,Osijek,Croatia, 2Josip Juraj Strossmayer University of Osijek,Faculty of Dental Medicine And Health,Osijek,Croatia, 3Department of Nuclear Medicine and Oncology ,Faculty of Medicine, Josip Juraj Strossmayer University of Osijek,Osijek,Croatia;Department of Oncology, Osijek University Hospital Centre,Osijek,Croatia, 4Faculty of Medicine, University of Mostar,Mostar,Bosnia and Herzegovina
Purpose
Dysphotopsias are still understudied post-surgical complications, but they are important because they can cause frustration in patients and become a leading factor in dissatisfaction after successful cataract surgery.
The aim of the study was to analyse the incidence and intensity of positive and negative dysphotopsias after monofocal hydrophobic acrylic intraocular lens (IOL) implantation depending on the position of the IOL (vertical, horizontal, superonasal, inferonasal).
This prospective cohort study included 80 patients divided into four equal groups based on the IOL position, who underwent PHACO cataract surgery and monofocal, hydrophobic acrylic, single-piece IOL implantation (Johnson & Johnson, model AAB00).
Setting
In the first group, the IOL was implanted vertically, in the second group horizontally, in the third group superonasally (135 degrees in the right eye and 45 degrees in the left eye), and in the fourth group inferonasally (45 degrees in the right eye and 135 degrees in the left eye). The control group comprised patients with horizontally implanted IOL.
Methods
All surgeries were performed by the same surgeon on Alcon Centurion ultraosund phacoemulsification device. One month after surgery, a disphotopsia questionnaire based on previously published studies was given to every patient consisting of five questions. Exclusion criteria were irregular preoperative astigmatism, history of corneal transplantation, prior refractive eye surgery, corneal disease including keratoconus, patients on long-term topical therapy, patients with dry eye, patients with central vision impairment due to any etiology affecting the visual center, patients with prior ocular surgery or laser procedures of any etiology, and patients with blunt or penetrating eye injury.
Results
Positive dysphotopsias appeared in 21 (26,3 %) patients, with no significant difference according to IOL position (Fisher's exact test, P =0,63). Negative dysphotopsias were recorded in 9 (11,3%) patients. Significantly higher negative dysphotopsias were associated with inferonasal and superonasal IOL positions (Fisher's exact test, P =0,01). There was no significant difference in the intensity of positive (Kruskal-Wallis test, P =0,33) and negative dysphotopsias (Kruskal-Wallis test, P =0,20), among patients experiencing dysphotopsias, concerning the IOL position.
Conclusions
A significant correlation was found between IOL position and the incidence of negative dysphotopsia,particularly in inferonasal and superonasal IOL positions.This suggests lens position may infulence post-surgery negative dysphotopsia perception.However,no significant difference was observed in the intensity of positive and negative dysphotopsia depending on IOL position Multiple therapeutics have been proposed to solve the problem such as piggy bag implantation,miotic drops,IOL replacement but without appropriate therapeutic effect.Additional studies with software or IOL design program on schematic eye models are necessary for solving disphotopsias and improve visual postsurgery outcome as therapeutic options are still quite unsuccessful.