PurposeTo determine whether horizontal orientation of the intraocular lens optic‐haptic junctions has an effect on the incidence of pseudophakic negative dysphotopsia.MethodsSingle‐centre prospective double‐masked randomized controlled trial. 220 eyes of 201 participants undergoing routine cataract surgery were randomized to receive their intraocular lens either orientated with the optic‐haptic junctions at 180° (‘horizontal’) or without manipulation following implantation (control). Patients were excluded according to age (<19 and > 99 years), coexisting eye disease affecting visual function and insufficient cognitive function to complete the study. In the fourth postoperative week, a telephone interview was conducted to determine rates of negative dysphotopsia. The data were analysed to provide the relative risk of negative dysphotopsia with horizontal orientation of the intraocular lens (IOL) optic‐haptic junctions compared with standard treatment.ResultsOrientating the IOL optic‐haptic junctions horizontally halved the incidence of pseudophakic negative dysphotopsia in the fourth postoperative week (9/110 in the intervention group; 18/110 in the control group; RR: 0.50, 95% confidence interval: 0.235–1.064, p = 0.072). The overall incidence of negative dysphotopsia was 12.2% (27/220 participating eyes). No intraoperative adverse effects of intraocular lens rotation were reported.ConclusionThe simple intraoperative manoeuvre of rotating the intraocular lens to orientate the optic‐haptic junctions at 180° may be a safe and effective measure to reduce the risk of developing postoperative pseudophakic negative dysphotopsia in the first postoperative month. This is the first report that demonstrates the benefit of horizontal optic‐haptic junction positioning to be sustained beyond the first postoperative day.
Children and young people living in CHH are a largely invisible and highly vulnerable population. Clear, officially accepted definitions of CHH are a first step in recognising this vulnerable group for whom safeguards will be necessary as social work develops in lower- and middle-income countries (LMICs). The precise numbers of CHH are unknown and further examination of this undocumented group is needed.
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