Screening of Positive Dysphotopsia Before Multifocal Intraocular Lens Implantation

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2024 Jan 25

PMID 38271416

Authors

Joaquin Fernandez

Noemi Burguera

Carlos Rocha-de-Lossada

Francisco Zamorano-Martin

Manuel Rodriguez-Vallejo

Affiliations

Soon will be listed here.

Abstract

Purpose: To assess the photic phenomena (PP) and positive dysphotopsia in candidates for presbyopia or cataract surgery and to evaluate their relationship with cataract grading systems.

Design: Retrospective observational.

Methods: Monocular data for 82 subjects measured during the preoperative screening were retrospectively retrieved from our database. The evaluated variables consisted of two methods for PP measurement: light distortion index (LDI) and parameters obtained from a simulator, both of which were combined with subjective bother related to PP. The cutoff for LDI that better predicted patients passing from slightly to moderately bothersome was estimated. The relationships between LDI and the following objective cataract grading methods were also assessed: objective scatter index (OSI), dysfunctional lens index (DLI), and Pentacam Nucleus Staging (PNS).

Results: LDI was the best method for measuring PP, which showed a significant correlation with the bothersome question (rho = 0.34, P = 0.002) and also with OSI (rho = 0.67, P < 0.0005), DLI (rho = -0.29, P = 0.007), and PNS (rho = 0.48, P < 0.0005). The number/percentage of patients who found it bothersome was as follows: "Not at all" (18/22%), "Slightly" (41/50%), "Moderately" (15/18.3%), and "Very" (8/9.7%). The cutoff value that predicted the transition from slightly to moderately bothersome was ≥15.20% according to LDI, which could be estimated with the following values for grading: ≥2.8 for OSI, ≤7.6 for DLI, and ≥2 for PNS.

Conclusions: Patients reporting moderately or higher bothersome levels in the preoperative period and with LDI <15.20%, <2.8 for OSI, >7.6 for DLI, and <2 for PNS might deserve special attention in the multifocal intraocular lens selection.

Citing Articles

Clinical Outcomes of a Trifocal Versus an Extended Depth of Field Intraocular Lens in Chinese Patients With Cataract: A Prospective Cohort Study.

Chen Q, Zhang G J Ophthalmol. 2024; 2024:5571802.

PMID: 39444423 PMC: 11496590. DOI: 10.1155/2024/5571802.

References

Amorim-de-Sousa A, Macedo-de-Araujo R, Fernandes P, Queiros A, Gonzalez-Meijome J . Impact of Defocus and High-Order Aberrations on Light Disturbance Measurements. J Ophthalmol. 2019; 2019:2874036. PMC: 6334342. DOI: 10.1155/2019/2874036. View

Alio J, Plaza-Puche A, Alio Del Barrio J, Amat-Peral P, Ortuno V, Yebana P . Clinical outcomes with a diffractive trifocal intraocular lens. Eur J Ophthalmol. 2018; 28(4):419-424. DOI: 10.1177/1120672118762231. View

Ison M, Scott J, Apel J, Apel A . Patient Expectation, Satisfaction and Clinical Outcomes with a New Multifocal Intraocular Lens. Clin Ophthalmol. 2021; 15:4131-4140. PMC: 8520966. DOI: 10.2147/OPTH.S327424. View

de Vries N, Webers C, Touwslager W, Bauer N, de Brabander J, Berendschot T . Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg. 2011; 37(5):859-65. DOI: 10.1016/j.jcrs.2010.11.032. View

Kim E, Na K, Kim H, Hwang H . How does the world appear to patients with multifocal intraocular lenses?: a mobile model eye experiment. BMC Ophthalmol. 2020; 20(1):180. PMC: 7201983. DOI: 10.1186/s12886-020-01446-5. View

Nixon D . Preoperative cataract grading by Scheimpflug imaging and effect on operative fluidics and phacoemulsification energy. J Cataract Refract Surg. 2010; 36(2):242-6. DOI: 10.1016/j.jcrs.2009.08.032. View

Woodward M, Randleman J, Stulting R . Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009; 35(6):992-7. PMC: 5125020. DOI: 10.1016/j.jcrs.2009.01.031. View

Fernandez J, Ribeiro F, Rodriguez-Vallejo M, Dupps Jr W, Werner L, Srinivasan S . Standard for collecting and reporting outcomes of IOL-based refractive surgery: update for enhanced monofocal, EDOF, and multifocal IOLs. J Cataract Refract Surg. 2022; 48(11):1235-1241. DOI: 10.1097/j.jcrs.0000000000001013. View

Fernandez J, Rodriguez-Vallejo M, Martinez J, Tauste A, Pinero D . From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome. J Ophthalmol. 2018; 2018:4318405. PMC: 6040261. DOI: 10.1155/2018/4318405. View

10.

Fernandez J, Rodriguez-Vallejo M, Martinez J, Burguera N, Pinero D . Long-Term Efficacy, Visual Performance and Patient Reported Outcomes with a Trifocal Intraocular Lens: A Six-Year Follow-up. J Clin Med. 2021; 10(9). PMC: 8125847. DOI: 10.3390/jcm10092009. View

11.

Kohnen T, Suryakumar R . Measures of visual disturbance in patients receiving extended depth-of-focus or trifocal intraocular lenses. J Cataract Refract Surg. 2020; 47(2):245-255. DOI: 10.1097/j.jcrs.0000000000000364. View

12.

Rudalevicius P, Lekaviciene R, Auffarth G, Liutkeviciene R, Jasinskas V . Relations between patient personality and patients' dissatisfaction after multifocal intraocular lens implantation: clinical study based on the five factor inventory personality evaluation. Eye (Lond). 2019; 34(4):717-724. PMC: 7093406. DOI: 10.1038/s41433-019-0585-x. View

13.

Youden W . Index for rating diagnostic tests. Cancer. 1950; 3(1):32-5. DOI: 10.1002/1097-0142(1950)3:1<32::aid-cncr2820030106>3.0.co;2-3. View

14.

Fernandez J, Burguera N, Rocha-de-Lossada C, Rachwani-Anil R, Rodriguez-Vallejo M . Influence of a multifocal intraocular lens centration and eye angles on light distortion and ocular scatter index. Graefes Arch Clin Exp Ophthalmol. 2023; 261(8):2291-2299. DOI: 10.1007/s00417-023-06028-x. View

15.

Brito P, Salgado-Borges J, Neves H, Gonzalez-Meijome J, Monteiro M . Light-distortion analysis as a possible indicator of visual quality after refractive lens exchange with diffractive multifocal intraocular lenses. J Cataract Refract Surg. 2015; 41(3):613-22. DOI: 10.1016/j.jcrs.2014.07.033. View

16.

Fernandez J, Rodriguez-Vallejo M, Martinez J, Tauste A, Garcia-Montesinos J, Pinero D . Agreement and repeatability of objective systems for assessment of the tear film. Graefes Arch Clin Exp Ophthalmol. 2018; 256(8):1535-1541. DOI: 10.1007/s00417-018-3986-9. View

17.

Ferreira-Neves H, Macedo-de-Araujo R, Rico-Del-Viejo L, da-Silva A, Queiros A, Gonzalez-Meijome J . Validation of a method to measure light distortion surrounding a source of glare. J Biomed Opt. 2015; 20(7):75002. DOI: 10.1117/1.JBO.20.7.075002. View

18.

Mester U, Vaterrodt T, Goes F, Huetz W, Neuhann I, Schmickler S . Impact of personality characteristics on patient satisfaction after multifocal intraocular lens implantation: results from the "happy patient study". J Refract Surg. 2014; 30(10):674-8. DOI: 10.3928/1081597X-20140903-05. View

19.

Vargas V, Ferreira R, Alio Del Barrio J, Alio J . Visual Outcomes, Patient Satisfaction, and Light Distortion Analysis After Blended Implantation of Rotationally Asymmetric Multifocal Intraocular Lenses. J Refract Surg. 2020; 36(12):796-803. DOI: 10.3928/1081597X-20200902-01. View

20.

Dubbelman M, van der Heijde G, Weeber H, Vrensen G . Changes in the internal structure of the human crystalline lens with age and accommodation. Vision Res. 2003; 43(22):2363-75. DOI: 10.1016/s0042-6989(03)00428-0. View