Don’t discount dysphotopsias, either positive or negative, after cataract surgery and IOL placement. The literature suggests that dysphotopsias are relatively rare, but patient reports suggest a different story.
Treating positive dysphotopsias is relatively straightforward. Explanting and exchanging the original lens with an IOL that has a different material or edge design usually reduces or removes the problem entirely. PMMA, silicone, and hydrophilic acrylic lenses with edge designs that are not square are reported to help resolve positive dysphotopsias.
“Negative dysphotopsias are completely different,” Dr. Mamalis said. “The more often you ask about negative dysphotopsias, the more frequently patients report those dark temporal shadows, especially in the first couple of weeks.”
About 71% of negative dysphotopsias resolve in the first weeks and months after surgery, he continued. Depending on how and when patients are questioned, between 0.2% and 2.4% have persistent symptoms.
“Don’t get too excited at first and try to do something about it immediately,” he advised. “In a lot of patients, it goes away.”
Nick Mamalis, MD
Dr. Mamalis is professor of ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City. He did not indicate any proprietary interest in the subject matter.