Pseudophakic negative dysphotopsia and intraocular lens orientation: a prospective double-masked randomized controlled trial.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE

Publication: Oxford, UK : Wiley-Blackwell
Original Publication: Oxford, UK ; Malden, MA : Blackwell Munksgaard

Lens Implantation, Intraocular/*methods ; Lenses, Intraocular/*adverse effects ; Pseudophakia/*etiology ; Vision Disorders/*etiology; Aged ; Aged, 80 and over ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pseudophakia/diagnosis ; Vision Disorders/diagnosis

Purpose: To determine whether horizontal orientation of the intraocular lens optic-haptic junctions has an effect on the incidence of pseudophakic negative dysphotopsia.
Methods: Single-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.
Results: Orientating 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.
Conclusion: The 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.
(© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

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Keywords: dysphotopsia; haptic; intraocular lens; negative; orientation; pseudophakic

Date Created: 20200205 Date Completed: 20210601 Latest Revision: 20210601

20250114

10.1111/aos.14368

32017373