Assessment of dysphotopsia in pseudophakic subjects with multifocal intraocular lenses


Aim: To better understand the phenomenon of dysphotopsia in patients implanted with multifocal intraocular lenses (IOLs). Methods: Forty-five patients (aged 61.8±8.9 years) implanted bilaterally with Tecnis ZM900 (diffractive multifocal), Lentis Mplus MF30 (segmented refractive multifocal) or Softec-1 (monofocal) IOLs (each n=15) 4–6 months previously and who had achieved a good surgical outcome were examined. Each reported their dysphotopsia symptoms subjectively, identified its form (EyeVisPod illustrations), quantified retinal straylight (C-Quant) and halo perception (Aston halometer). Retinal straylight and halometry was repeated by a second masked clinician to determine interobserver repeatability. Results: Subjective dysphotopsia ratings were able to differentiate Tecnis ZM900 from Lentis Mplus MF30 (p<0.001), but not Lentis Mplus MF30 from groups implanted with Softec-1 (p=0.290). Straylight was similar between the monofocal and multifocal IOL designs (p=0.664). ZM900 IOLs demonstrated a uniform increase in dysphotopsia in comparison with the monofocal IOL (p<0.001) as measured with the halometer, whereas sectorial refractive multifocal IOLs demonstrated a localised increase in dysphotopsia over the inferior visual field. Intraobserver repeatability was good for the straylight (intraclass correlation coefficients (ICC)=0.77) and halometry (ICC=0.89). There was no significant correlation between the subjective dysphotopsia severity and the straylight (p=0.503) or halometry (p>0.10) quantification or between straylight and the halo area (p>0.30). Conclusions: Multifocal IOLs induce symptoms of dysphotopsia. Straylight did not differentiate between IOL designs, however halometry identified clear differences in light scatter due to the IOL optics. Whereas, subjective rating of overall dysphotopsia are not strongly associated with straylight or halo perception, the halometry polar diagram reflected the subjective descriptions of dysphotopsia.

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Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
Additional Information: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Publication ISSN: 2397-3269
Last Modified: 08 Jul 2024 07:33
Date Deposited: 06 Sep 2017 12:40
PURE Output Type: Article
Published Date: 2017-06-19
Accepted Date: 2017-05-07
Authors: Buckhurst, Philip J.
Naroo, Shehzad A. (ORCID Profile 0000-0002-6373-7187)
Davies, Leon N. (ORCID Profile 0000-0002-1554-0566)
Shah, Sunil (ORCID Profile 0000-0002-5373-5305)
Drew, Tom
Wolffsohn, James S. (ORCID Profile 0000-0003-4673-8927)



Version: Published Version

License: Creative Commons Attribution

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