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Review
. 2022 Dec 24;13(1):53.
doi: 10.3390/life13010053.

Dysphotopsias or Unwanted Visual Phenomena after Cataract Surgery

Ambroz Pusnik  1 , Goran Petrovski  2   3   4 , Xhevat Lumi  1   2   5
Affiliations
Review

Dysphotopsias or Unwanted Visual Phenomena after Cataract Surgery

Ambroz Pusnik et al. Life (Basel). .

Abstract

Dysphotopsias are unwanted visual phenomena that occur after cataract surgery. They represent some of the most common reasons for patient dissatisfaction after uncomplicated surgery for cataract phacoemulsification with in-the-bag intraocular lens (IOL) implantation. Depending on the form of the optical phenomenon and the effect it poses on vision, dysphotopsias are divided into positive and negative type. Positive dysphotopsias are usually described by patients as glare, light streaks, starbursts, light arcs, rings, haloes, or flashes of light. Negative dysphotopsias are manifested as an arc-shaped shadow or line usually located in the temporal part of the visual field, similar to a temporal scotoma. In addition to their different clinical manifestations, positive and negative dysphotopsia also have different risk factors. Even though up to 67% of patients may experience positive dysphotopsia immediately after surgery, only 2.2% of the cases have persistent symptoms up to a year postoperatively. Surgical intervention may be indicated in 0.07% of cases. The incidence of negative dysphotopsias is up to 26% of all patients; however, by one year postoperatively, the symptoms usually persist in 0.13 to 3% of patients. For both types of dysphotopsia, preoperative patients' education, accurate preoperative diagnostics, and use of an appropriate IOL design and material is mandatory. Despite all these measures, dysphotopsias may occur, and when noninvasive measures fail to improve symptoms, a surgical approach may be considered.

Keywords: cataract surgery; intraocular lens; negative dysphotopsia; positive dysphotopsia; unwanted visual phenomena.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
IOL shape: sharp-edge (A) versus rounded-edge (B) design and the aberrant visual phenomena associated with incident light coming from the temporal direction.
Figure 2
Figure 2
Visual phenomena in positive dysphotopsia—glare (A), and negative dysphotopsia—temporal arc-shaped shadow (B).
Figure 3
Figure 3
“Illumination gap” theory—a gap between the different refraction of rays hitting the IOL optic periphery (yellow) and the rays that miss the IOL (red).
Figure 4
Figure 4
Time course of dysphotopsia symptom persistence.
Figure 5
Figure 5
Course of treatment flowchart for patients with dysphotopsia.
See this image and copyright information in PMC

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