Refractive index and its impact on pseudophakic dysphotopsia

Abstract

Bryce R Radmall,1 Anne Floyd,2 Zack Oakey,3 Randall J Olson4 1Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, 2Department of Ophthalmology, Louisiana State University Health Sciences Center, Shreveport, LA, 3Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, CA, 4Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA Purpose: It has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD). While edge design of an intraocular lens (IOL) impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD. Patients and methods: This study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00]), which differed mainly by refractive index (1.55 versus 1.47). Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality. Results: Statistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction. Conclusion: The study suggests that with the two IOLs assessed, increasing the refractive index does not increase incidence of PD or decrease overall visual satisfaction. Keywords: cataract, phacoemulsification, refractive index, visual function, patient satisfaction