Negative Dysphotopsia Secondary to Poor Wound Construction in Femtosecond Laser-Assisted Cataract Surgery
Narrative Responses:
Purpose
To evaluate the feasibility of avoiding femtosecond induced negative dysphotopsias following cataract surgery by performing cataract surgery with a manual peripheral corneal incision.
Methods
This case study is of a 64 year old man with complaints of negative dysphotopsia following cataract surgery (OS). Examination showed a centrally displaced temporal corneal incision initiated 0.50 mm from the limbus (femtosecond incision). The patient had a small pupil (4mm scotopic) and a well positioned posterior chamber IOL. The symptoms were elicited with a temporal light source but not with a nasal light source (tested with right head turn/ left gaze to remove any light-blocking from the patient’s nose), supporting the incision as the symptom’s culprit. Surgery in the fellow eye was performed with a manual, peripheral incision.
Results
Following cataract surgery on the fellow eye, by the first postoperative day the patient had 20/25 uncorrected distance vision OD and no dysphotopsias. He has remained stable (now 2 months postoperatively) and continues to note dysphotopsias from his left eye.
Conclusion
Minimizing the incidence of negative dysphotopsias following cataract surgery may involve avoiding placing the incision too far centrally. This may be easier to accomplish with a manual incision rather than a femtosecond laser. Further study is warranted.