Refractive index and its impact on pseudophakic dysphotopsia

Abstract

PurposeIt has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD). While edge design of an intraocular lens (IOL) impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD.Patients and methodsThis study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00]), which differed mainly by refractive index (1.55 versus 1.47). Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality.ResultsStatistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction.ConclusionThe study suggests that with the two IOLs assessed, increasing the refractive index does not increase incidence of PD or decrease overall visual satisfaction.

Cyclodextrin-containing hydrogels as an intraocular lens for sustained drug release

“…Moreover, the incorporation of Triple-MA-β-CD enhanced these chain-like structures. The RI of commercial hydrophilic acrylic IOLs is approximately 1.46 ± 0.3 [ 44 ]. In addition, IOLs that consist of materials with a higher RI can be much thinner, which would be helpful for reducing the size of surgical incisions, especially during minimally invasive cataract surgery [ 45 ].…”

Aktuelle Übersicht: multifokale Linsen und Extended-Depth-of-Focus-Intraokularlinsen

“…Auch das Kantendesign spielt eine entschei-dende Rolle. Nicht abgeschnittene, also doppelt scharfe Kanten, können an IOL-Designs ein Geisterbild erzeugen, das bis zu 10mal intensiver ist als bei einer doppelt abgerundeten IOL [58].…”

“…Positive Dysphotopsiesymptome werden als helle Blitze, Lichtbögen, Halos oder Lichtreflexe beschrieben und sind meist bei skotopischen Lichtverhältnissen, unter denen sich die Iris erweitert, am stärksten [58]. Negative Dysphotopsie ist durch einen wahrgenommenen Schatten im temporalen Gesichtsfeld gekennzeichnet.…”