Intraocular lens exchange in patients with negative dysphotopsia symptoms
Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Francisco, California, USA, April 2009.
Received 31 May 2009; received in revised form 1 October 2009; accepted 7 October 2009.
Purpose
to evaluate the results of intraocular lens (IOL) exchange in cases of severe negative dysphotopsia and to measure the distance between the iris and the IOL optic using ultrasound biomicroscopy (UBM).
Setting
Szent Rókus Hospital and Eye Clinic, Semmelweis University, Budapest, Hungary.
Methods
Data of patients with major negative dysphotopsia symptoms after phacoemulsification with IOL implantation were reviewed retrospectively. In cases in which IOL exchange was performed to diminish the symptoms, the distance between the iris and the anterior surface of the IOL optic was measured by UBM and compared with that in a group of nonsymptomatic pseudophakic patients (control group).
Results
in 3806 cataract procedures, 5 eyes (4 patients) had severe negative dysphotopsia symptoms. Intraocular lens exchange was performed in 3 cases. In 1 case, the secondary IOL was implanted in the reopened capsular bag and the symptoms persisted. In 2 cases, the secondary IOL was implanted in the ciliary sulcus and the symptoms resolved. On UBM, the mean iris–optic distance was 0.45 mm ± 0.07 (SD) in the symptomatic group, 0.59 ± 0.29 mm in the control group (n = 21) (P = .353), and 0.00 mm in the sulcus-fixated group.
Conclusions
The iris–optic distance was not statistically significantly different between eyes with severe negative dysphotopsia symptoms and nonsymptomatic eyes. However, when IOL exchange reduced the iris–IOL distance, the severe negative dysphotopsia symptoms resolved.
Financial Disclosure
No author has a financial or proprietary interest in any material or method mentioned.
From the Department of Ophthalmology (Vámosi), Szent Rókus Hospital, and the Eye Clinic (Csákány, Németh), Semmelweis University, Budapest, Hungary
Corresponding author: Péter Vámosi, MD, PhD, Department of Ophthalmology, Szent Rókus Hospital, Budapest, H-1085, Hungary.
ABSTRACT