A modified intraocular lens design to reduce negative dysphotopsia

Purpose: To use ray-tracing analysis and simulated retinal illumination profiles to design an intraocular lens (IOL) that prevents or reduces negative dysphotopsia after cataract surgery. Setting: Mayo Clinic, Rochester, Minnesota, and Simpson Optics LLC, Arlington, Texas, USA. Design: Experimental study. Methods: Ray-tracing software was used to simulate peripheral retina illumination from an extended light source for a pseudophakic eye with a biconvex high refractive index IOL. Ray intensities were adjusted to include the effects of the surface reflections and the energy reduction caused by pupil obliquity at high incident angles. The results were compared with similar optical modeling of a modified IOL design with a concave region on the peripheral posterior surface. Results: For a standard biconvex high refractive index IOL, simulated retina illumination profiles showed an area of nonilluminated peripheral nasal retina at a relative visual angle of approximately 85 degrees to 93 degrees. Using a modified IOL optic with a peripheral concave posterior surface, ray-tracing diagrams showed that peripheral input rays were redirected anteriorly into the nonilluminated dark area of the peripheral retina. Simulated retina illumination images confirmed that the redirected input rays improved illumination to the peripheral retina, including the dark area. Conclusions: Optical modeling showed that the new IOL design provides more uniform illumination of the peripheral nasal retina and specifically illuminates the dark region of the nasal retina associated with negative dysphotopsia. This modified IOL design could prevent or reduce negative dysphotopsia after cataract surgery. (C) 2019 ASCRS and ESCRS