PubMed Health⌕ Search

PubMed · 16436921

Recent developments in pseudophakic dysphotopsia.

Abstract

PURPOSE OF REVIEW: Photic phenomena associated with intraocular lenses can degrade visual performance following intraocular lens implantation. Postoperative dysphotopsia introduces glare, halos, starbursts and shadows in a small number of patients. Understanding the optical mechanisms behind the introduction of these artifacts can lead to improved lens design and a reduction in the deleterious effects of stray light. This review looks at the improvement efforts of recent years to illustrate the systematic hunt for lens problems. RECENT FINDINGS: Improvements in edge designs have diminished the effects of positive dysphotopsia. However, negative dysphotopsia remains poorly understood and a variety of lens designs and materials can cause negative dysphotopsia. In other efforts, a testing procedure has been developed to improve understanding of the visual percept of a patient suffering dysphotopsia. This test should enlighten practitioners to the deficits their patients face and provide clues to the root causes of the problems. SUMMARY: Intraocular lenses can introduce stray light artifacts into the eye. These artifacts manifest themselves as glare, halos, starbursts and shadows. While positive dysphotopsia (glare, halos and starbursts) has been largely attributed to edge effects of the implant, negative dysphotopsia remains somewhat mysterious and appears to be more related to the patient's anatomical structure than to specific lens designs or materials.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Jim Schwiegerling. 2006. Recent developments in pseudophakic dysphotopsia.. https://doi.org/10.1097/01.icu.0000193065.09499.7e

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Using a human visual system model to optimize soft-copy mammography display: influence of veiling glare.

RATIONALE AND OBJECTIVES: This project evaluated human observer performance and that of a human visual system model (JNDmetrix) to assess whether the veiling glare of a digital display influences observer performance during soft-copy interpretation of mammographic images for the detection of masses. MATERIALS AND METHODS: A set of 160 mammographic images, half containing a single mass, was processed to simulate four levels of veiling glare: none, comparable to a medical grade monochrome curved-screen cathode ray tube (CRT) display, double that of the CRT and quadruple that of the CRT. The images were shown to six observers in a randomized presentation order on a liquid crystal display (LCD) that had essentially no veiling glare. The images were also analyzed using the JNDmetrix human visual system model. RESULTS: Observer performance as measured using receiver operating characteristic techniques declined with increasing veiling glare (F = 6.884, P = .0035), with quadruple veiling glare yielding significantly lower performance than the lower veiling glare levels. The JNDmetrix model did not show a large reduction in performance as a function of veiling glare, and correlation with the human observer data was modest (0.588). CONCLUSIONS: Soft-copy display veiling glare can influence observer performance, but only at extreme levels. The impact of veiling glare on performance may be more pronounced for less experienced readers.

Glare↗

Subjective photic phenomena with refractive multifocal and monofocal intraocular lenses. results of a multicenter questionnaire.

PURPOSE: To compare the incidence and severity of photic phenomena after the implantation of the Array(R) (Allergan) refractive multifocal intraocular lens (MIOL) and a monofocal IOL. SETTING: Multicenter study at Kiel, Mainz, Karlsruhe, and Bremerhaven, Germany. METHODS: The study comprised 231 randomly selected patients from 4 study centers. The patients had had uneventful phacoemulsification with implantation of a refractive MIOL (n = 138) or a monofocal IOL (n = 93). By questionnaire, patients were asked whether they experienced light sensations postoperatively (light streaks, halos, flare, flashes, or glare) that had not been noticed preoperatively. Additional questions evaluated whether these phenomena had changed over time and how much they affected the patients' quality of life. RESULTS: Overall, 9% of patients with a monofocal IOL and 41% of those with an MIOL reported photic phenomena that had not been noticed before cataract surgery. Halos and flare were mentioned significantly more often by patients with MIOLs than by those with monofocal IOLs. There was no significant between-group difference in the mention of flashes. Eighteen percent of patients with MIOLs and 4% with monofocal IOLs were slightly or moderately bothered by the photic phenomena, whereas 5% of patients with MIOLs and none in the monofocal group were severely disturbed by the light sensations. CONCLUSION: Subjective photic phenomena were experienced significantly more often by patients who had refractive MIOLs than by those who had monofocal IOLs. The differences in the results of the 4 study centers were probably influenced by different patient selection criteria for the implantation of MIOLs.

Glare↗