Dysphotopsias with aspherical foldable (Acrysof SN60WF ) intraocular lens A preliminary report

1. Dysphotopsias with aspherical foldable (Acrysof SN60WF) intraocular lens A preliminary report Charith Fonseka Colombo Eye Hospital Sri Lanka

2. Introduction • Dysphotopsias are unwanted visual sensations and can cause patient dissatisfaction after otherwise successful cataract surgery • They have been attributed predominantly to edge design and the high refractive index of IOLs

3. Purpose • A preliminary report of a prospective study of Dysphotopsias, following implantation of an Acrysof SN60WF IOL in 760 consecutive adult eyes after standard phacoemulsification. • Assess the incidence • Assess any associated factors with • positive Dysphotopsias • negative Dysphotopsias

4. Population • Sri Lanka is a south Asian country with a highly literate population • Ambient night time lighting (indoor and outdoor) is much less than in countries of the western hemisphere

5. Methods • Data of 280 of the 760 consecutive adult eyes scheduled for standard microcoxial (2.2mm) phacoemulsification with an Alcon infinity system (torsional) with implantation of an Acrysof SN60WF IOL were included. • Exclusion criteria • Eyes with copathology • per or post operative complications were excluded.

6. Methods - Data collected • Age gender and laterality • IOL power, pre op K readings, axial length measurement of white to white diameter and anterior chamber depth. • First or second eye • Occupation, leisure activities, and hobbies and driving. • Second post operative visit (mean 36.4 days post op)

7. Post op K values, surgical astigmatism anterior chamber depth and refraction were assessed. • Complaints about quality of vision if volunteered were recorded. • Questioned about presence of dysphotopsias • positive (shimmering or pulsating light, arc, flare, central flash or haloes) • negative (temporal darkness) • All patients who complained are being telephone interviewed at 3 months post surgery to determine the status of dysphotopsias.

8. Results

9. Results

10. Results • Types of positive dysphotopsias • arcs of light 9 • Central flashes 3 • Ghost images or shadows 2 • Types of negative dysphotopsias • Temporal darkness 2 • Sense of lateral part of upper lid not completely opening 3

11. Results • Statistical analysis did not show any association of Anterior chamber depth, lens power, laterality with dysphotopsias • Total percentage with dysphotopsias – 6.7% • Volunteered dysphotopsias – 3.5% • Positive dysphotopsias – 5% • Negative dysphotopsias – 1.7%

12. Conclusions • Dysphotopsias tend to be low in Sri Lankan patients undergoing implantation with Acrysof aspherical IOLs. • Severe dysphotopsia is almost never seen