Distinct differences in anterior chamber configuration and peripheral aberrations in negative dysphotopsia

Journal of Cataract & Refractive Surgery, vol. 46, pp. 1007–1015

Abstract

PURPOSE: To provide insights into the anatomical characteristics associated with negative dysphotopsia using quantitative clinical data. SETTING: Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands. DESIGN: Case-control study. METHODS: Anterior chamber tomography and peripheral aberrometry were measured in 27 pseudophakic patients with negative dysphotopsia and 30 pseudophakic control subjects. Based on these measurements, the total corneal power, anterior chamber depth, pupil location and diameter, iris tilt, and peripheral ocular wavefront up to 30 degrees eccentricity were compared between both groups. In addition, ray-tracing simulations using pseudophakic eye models were performed to establish a connection between these clinical measurements and current hypotheses on the etiology of negative dysphotopsia. RESULTS: Twenty-seven patients with negative dysphotopsia and 25 pseudophakic controls were included in the analysis. The patients with negative dysphotopsia had a smaller (P = .03/P = <.01) and more decentered (P < .01) pupil than that of the pseudophakic controls. In addition, an increased temporal-tilted iris (P < .01) and an asymmetric peripheral aberration profile were observed in patients with negative dysphotopsia, of which the latter was also apparent in several ray-tracing models. The combination of these in vivo results and ray-tracing simulations indicated that patients with negative dysphotopsia had a temporal-rotated eye, which confirmed the hypothesized relation between negative dysphotopsia and an increased angle κ. CONCLUSIONS: Patients with negative dysphotopsia had a smaller pupil and an increased angle κ, which made them more susceptible to experiencing a shadow in the temporal visual field.

Authors 3

1. Luc van Vught Aachen Department of Ophthalmology (van Vught Department of Radiology C.J. Gorter Center for High Field MRI (van Vught First author:Luc van Vught

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   From the Department of Ophthalmology (van Vught, Luyten, Beenakker), and the Department of Radiology, C.J. Gorter Center for High Field MRI (van Vught, Beenakker), Leiden University Medical Center, Leiden, the Netherlands

   First author:Luc van Vught, BScDepartment of Ophthalmology, Leiden University Medical Center, the Netherlands

   the Department of Ophthalmology (van Vught, Luyten, Beenakker), and the Department of Radiology, C.J. Gorter Center for High Field MRI (van Vught, Beenakker), Leiden University Medical Center, Leiden, the Netherlands

2. Gregorius P. M. Luyten Aachen Department of Ophthalmology (van Vught Department of Radiology C.J. Gorter Center for High Field MRI (van Vught

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   the Department of Ophthalmology (van Vught, Luyten, Beenakker), and the Department of Radiology, C.J. Gorter Center for High Field MRI (van Vught, Beenakker), Leiden University Medical Center, Leiden, the Netherlands

3. Jan‐Willem M. Beenakker Aachen Department of Ophthalmology (van Vught Department of Radiology C.J. Gorter Center for High Field MRI (van Vught

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   the Department of Ophthalmology (van Vught, Luyten, Beenakker), and the Department of Radiology, C.J. Gorter Center for High Field MRI (van Vught, Beenakker), Leiden University Medical Center, Leiden, the Netherlands