Reduced Incidence of Negative Dysphotopsia With Scleral-Fixated Intraocular Lenses

To determine the incidence of negative dysphotopsia (ND) in eyes with scleral-fixated intraocular lenses (SFIOLs) absent the capsular bag remnant.

Private ophthalmology practice.

Retrospective observational study.

Consecutive cases of patients undergoing SFIOL without a capsule bag remnant were reviewed. Patients were excluded if they had conditions that could impact visual field testing, iris or pupil abnormalities, best-corrected visual acuity worse than 20/50, or clinically significant corneal pathology. Eligible patients were contacted via email and if they agreed to participate, a telephone interview with a novel questionnaire was completed after the patient reviewed a representative image of an ND scotoma.

Of 206 identified scleral-fixated IOL cases, 50 patients met inclusion criteria and agreed to complete the novel questionnaire. None of the 50 patients reported symptoms of ND at any time following surgery.

Negative dysphotopsia was not observed in this cohort of SFIOLs without a capsule bag remnant. These findings support the hypothesis that ND occurs primarily with "in-the-bag" IOLs and that the lens capsule, in some fashion, may play a role in the development of ND and suggest that existing optical modeling tests alone may be insufficient to explain the etiology for ND.