Consistent with a new hypothesis, resolution of negative dysphotopsia symptoms depended on IOL coverage of the anterior capsule edge rather than on collapse of the posterior chamber alone. Furthermore, negative dysphotopsia was not attributed to a particular IOL material or edge design. .

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Negative dysphotopsia was associated with acrylic or silicone IOLs of either square- or round-edge design. Negative dysphotopsia was reduced, eliminated, or prevented when the IOL optic overlaid the anterior capsulotomy rather than when the capsule edge overlaid the optic. Bag-to-sulcus IOL exchange and reverse optic capture were highly successful in managing or preventing negative dysphotopsia.

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Negative dysphotopsia is a relatively common photic phenomenon that may occur after implantation of an intraocular lens. The etiology of negative dysphotopsia is not fully understood. In this investigation, optical modeling was developed using nonsequential-component Zemax ray-tracing technology to simulate photic phenomena experienced by the human eye. The simulation investigated the effects of pupil size, capsulorrhexis size, and bag diffusiveness. Results demonstrated the optical basis of negative dysphotopsia. We found that photic structures were mainly influenced by critical factors such as the capsulorrhexis size and the optical diffusiveness of the capsular bag. The simulations suggested the hypothesis that the anterior capsulorrhexis interacting with intraocular lens could induce negative dysphotopsia.

Drs. Berdahl and Ayres are consultants to Bausch & Lomb, Inc. Drs. Ayres and Fram have received speaker fees from Bausch & Lomb. Dr. Terveen does not have a financial or proprietary interest in any material or methods mentioned.