Dysphotopsias and Vitrectomy: When, How, Why

Course overview

Frank S Siringo, MD, OD and James (Yunbo) Tian, MD This talk will give a detailed explanation of both positive and negative dysphotopsias, identify their risk factors, and explore their medical and surgical treatment options. This talk will go through ray tracing explanations of dysphotopsias, discuss IOL factors such as material, size, orientation, concavity, and anatomic factors such as pupil size, location, angle kappa, incision location. We will discuss conservative management of pupil size control, sunglasses, refractive error and dry eye management, as well as surgical options such as lens exchange, piggyback lenses, YAG procedures, reverse optic capture, and vitrectomy. The second half of this talk will discuss patient selection for vitrectomy for floaters. Indications for the procedure will be enumerated, such as duration of symptoms and impact on vision related quality of life. Symptoms will be categorized as either/both discrete opacities vs diffuse reduction in contrast sensitivity. Patient-centered factors predictive of recalcitrant symptoms, such as corneal and lens status, will be explored. Pre-operative risk factors for complications will be discussed. Anesthesia and operative technique will round out the talk, which will end with a question and answer period.