title: Pseudophakic negative dysphotopsia: Surgical management and new theory of etiology.
abstract: OBJECTIVE
  To evaluate the benefit of various surgical methods to address pseudophakic negative dysphotopsia.
  
  
  METHODS
  Private practice, Los Angeles, California, USA.
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  The following 4 surgical methods were used to treat negative dysphotopsia: secondary piggyback intraocular lens (IOL) implantation, reverse optic capture, in-the-bag IOL exchange, and iris suture fixation. Ultrasound biomicroscopy (UBM) was used to analyze posterior chamber anatomy. The primary outcome was partial or complete resolution of the negative dysphotopsia symptoms 3 months postoperatively.
  
  
  RESULTS
  Twelve eyes of 11 patients with negative dysphotopsia had surgical treatment. All 10 patients who had piggyback IOL implantation or reverse optic capture had partial or complete resolution of symptoms by 3 months. No patient who had in-the-bag IOL exchange (n = 3) or iris suture fixation of the capsular bag-IOL complex (n = 1) improved despite alteration of IOL material or edge design in the case of IOL exchange or UBM confirmation of posterior chamber collapse in the case of iris suture fixation of the capsular bag-IOL complex.
  
  
  CONCLUSIONS
  Consistent with a new hypothesis, resolution of negative dysphotopsia symptoms depended on IOL coverage of the anterior capsule edge rather than on collapse of the posterior chamber alone. Furthermore, negative dysphotopsia was not attributed to a particular IOL material or edge design. .
authors.affiliation: Advanced Vision Care and the David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA. avcmasket@aol.com
authors.forename: Samuel
authors.initials: S
authors.lastname: Masket
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Fram
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery*