J Korean Ophthalmol Soc.  2014 May;55(5):669-678. 10.3341/jkos.2014.55.5.669.

Clinical Characteristics and Patient's Satisfaction in Pseudophakic Negative Dysphotopsia

• Kim JA
• Ha AN
• Kwon JW
• Wee WR
• Han YK

• KMID: 2218087
• DOI: http://doi.org/10.3341/jkos.2014.55.5.669

Abstract

PURPOSE
To investigate the clinical characteristics of patients with pseudophakic negative dysphotopsia after cataract surgery and to analyze the risk factors of pseudophakic negative dysphotopsia as well as the postoperative effects on patient's satisfaction.
METHODS
This study included 1,020 eyes of 690 patients who underwent phacoemulsification and posterior chamber lens insertion between January 2010 and March 2012. Retrospective chart review was conducted to evaluate the prevalence of negative dysphotopsia according to the site of clear corneal incision during cataract surgery and the type of implanted intraocular lens (IOL). The clinical outcome of Neodymium:yttrium-aluminium-garnet (Nd:YAG) laser anterior capsulotomy in negative dysphotopsia patients was evaluated. Using a telephone survey, patients were asked to subjectively answer 18 questions regarding satisfaction after cataract surgery, the severity of visual symptoms and the effect of negative dysphotopsia in their daily life.
RESULTS
Negative dysphotopsia developed in patients who underwent uneventful cataract surgery and successful implantation of IOL in the bag. The patients' vision was corrected up to 20/20 (0.00 log MAR) and HVF P60-4 showed no abnormality in their visual field. There were significantly more patients with the SN60WF IOL who reported negative dysphotopsia but no other factors associated with the prevalence of negative dysphotopsia. During the telephone survey, patients complained of difficulties in their daily life related to the negative dysphotopsia symptoms and reported decreased satisfaction after cataract surgery.
CONCLUSIONS
Although negative dysphotopsia can decrease the patient's satisfaction after cataract surgery, the genesis of negative dysphotopsia and an objective method to test for negative dysphotopsia is necessary. Therefore, a prospective large study should be conducted to evaluate the cause and treatment of negative dysphotopsia.

Keyword

Cataract surgery; Negative dysphotopsia; Patient's satisfaction; Pseudophakia

MeSH Terms

Cataract
Humans
Lenses, Intraocular
Phacoemulsification
Prevalence
Pseudophakia
Retrospective Studies
Risk Factors
Telephone
Visual Fields

Figure

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  Figure 1. Negative dysphotopsia seen by patient in the temporal field. (A) Case 1 complained of a temporal dark shadow in her left eye 1 week after cataract surgery. (B) Case 7 complained of a semicircular shadow in her both eyes 1 month after cataract surgery.

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  Figure 2. Prevalence of negative dysphotopsia according to implanted intraocular lens. Prevalence of negative dysphotopsia was different among the groups (p = 0.039, Fisher's exact test). Subgroup analysis showed that the prevalence of negative dysphotopsia in the group 3 is statistically higher than that of group 1 (p = 0.025, Fisher's exact test). However, there is no statistically significant difference of prevalence of negative dysphotopsia between the group 2 and group 3, and between the group 1 and group 2 (p = 0.122, 0.268, respectively, Fisher's exact test). Group 1 : who have never complained of negative dysphotopsia (Toric IOL, HOYA YA-60BB, HOYA PC-60AD, or Tecnis ZA9003); Group 2: who were implanted with Akreos Adapt AO; Group 3: who were implanted with Acrylsof® SN60WF.

Reference

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