The aim of this review is to present the most recent knowledge, based on available references, about the problem of negative dysphotopsias, which occur after cataract surgeries. It seems however, despite being quite frequent when taking into account the number of cataract excisions, it lacks common knowledge. Up to this day, the principle of the symptom has a lot of unknowns. Surgical and non-surgical solutions used in cases of unacceptable levels of patient symptoms will be discussed.
Objective: This article aims to briefly characterise the most popular IOLs on the market and focus on Rayner EMV: monofocal plus lens being a very good compromise between a good deal of spectacle independence, its price and coexisting ocular conditions allowing for its implantation. Setting the postoperative refraction at minimonovision as was done in this study allows for even greater depth of field and thus minimalizes the need for glasses when performing most everyday activities. Methods: To summarise the IOLs characteristics a literature search was conducted. In the second part of the article surgeons’ own experience is shown together with postoperative results and patients’ satisfaction survey. Results: Uncorrected binocular visual acuity was very high: 74% of patients reached 6/6 on Snellen chart or better, and for 96% of patients mean UCVA both eyes was 6/6.5 or better. Mean binocular UCVA both eyes was 6/5.5. Near visual acuity score: 43% of patients did not require spectacle correction for near reading and 91% of patients were able to read line D-0,75 or more on Snellen reading chart. Halo or glare effect were noted in 5 cases but only in two of them resulted in lower score in patients’ satisfaction questionnaire (to 64 and 79% of maximum score). In three remaining cases patients gave 95% of maximum score and stated that even though they noted halo and / or glare it did not comprise their visual quality. In patients’ satisfaction questionnaire score given by drivers was 90%; non-drivers were even more satisfied and gave 92% of maximum score – it shows very high percentage of satisfied patients in both groups. Conclusion: Rayner EMV IOL is an affordable and valuable option for patients who would like to increase their spectacle independence postoperatively and should be considered along with premium multifocal IOLs. Reducing spectacle dependence with the pseudophakic mini-monovision technique could improve the functionality, independence and quality of life for many patients.
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