Satisfaction and dysphotopsia in the pseudophakic patient

To examine factors that influence satisfaction after uncomplicated cataract surgery.

Retrospective case review and examination of patients.

Sixty-one consecutive patients, seen at the John A. Moran Eye Center, University of Utah School of Medicine, who had uncomplicated cataract surgery from 1 practice and 40 consecutive control patients who met the inclusion criteria and were willing to participate.

Inclusion criteria were best-corrected visual acuity (BCVA) of at least 20/20, without any ocular disease that might affect vision. Patients were given a complete ophthalmic examination, had photos of the intraocular lens (IOL) and capsule taken, and were asked questions about dysphotopsia and satisfaction. A group of patients >65 years old with 20/20 BCVA and without other ophthalmic diagnoses were recruited, asked the same questions, and compared.

The only significant correlation with dissatisfaction was dysphotopsia (r = 0.602, CI 0.42-0.74, p < 0.0001). BCVA, uncorrected visual acuity, posterior capsular opacification, and anterior capsule overlap of the optic were not significantly correlated. The IOL patients were significantly worse for reported glare (p < 0.0001), photophobia (p < 0.0001), and flashes of light (p = 0.0002), but not for halos.

While satisfaction with cataract removal and IOL placement is high, dysphotopsia is the most important contributor to dissatisfaction and is relatively common. Furthermore, these symptoms are much worse than in age-matched controls. Research seeking to ameliorate dysphotopsia is clinically important.