Post-capsulotomy dysphotopsia in monofocal versus multifocal lenses.
OBJECTIVE
To compare the photic symptoms experienced by patients with the monofocal SI30 intraocular lens (IOL) with the refractive multifocal SA40 Array IOL after capsulotomy.


METHODS
In this prospective cohort study, 49 eyes of 49 patients (20 multifocal, 29 monofocal IOLs) were assessed following uncomplicated cataract extraction and Nd:YAG capsulotomy equal to the scotopic pupillary diameter. Subjects with post-operative refraction of +/-1.00 or more DS, +/-1.00 or more DC, concurrent ocular pathology, LogMAR acuity of worse than 0.3 for distance or 1.0 for near were excluded. Glare and halo were assessed objectively with computer-generated psychophysical tests (Glare and Halo) and subjective dysphotopic symptoms were evaluated with Tester, Javitt, Winther-Neilsen and Sedgewick questionnaires.


RESULTS
No significant difference was found for mean halo size (square degrees) between monofocals (121.33) and multifocals (97.32, p = 0.207) or for mean glare (percentage contrast), monofocals (7.881) and multifocals (7.353, p = 0.812). No significant differences in the subjective appreciation of dysphotopsia were found: Tester (p = 0.358), Javitt (p = 0.29), Winther-Neilson (p = 0.54) and Sedgewick questionnaires (p = 0.134).


CONCLUSIONS
The posterior capsule is an important optical medium, which has not been fully considered in other comparative studies and its complete removal eliminates any confounding contribution. The results suggest that after capsulotomy, there is no significant difference in objective or subjective photic phenomena between monofocal and multifocal silicone lenses. Dysphotopic symptoms in patients with refractive multifocal IOLs were comparable to monofocal IOL patients after capsulotomy.
Allen
Richard
R
Department of Ophthalmology, Essex County Hospital, Colchester, Essex, UK. Richardallen_@btopenworld.com
Ho-Yen
Gregory O
GO
Beckingsale
Adrian B
AB
Fitzke
Fred W
FW
Sciscio
Andrea G
AG
Saleh
George M
GM
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D015331:Cohort Studies; D004867:Equipment Design; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D012542:Scattering, Radiation; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology