Supplementary Implantation of 1stQ AddOn(®) Sulcus-Fixated Intraocular Lens to Treat Negative Dysphotopsia: A Retrospective Case Series

Negative dysphotopsia (ND) refers to the subjective perception of an arc-shaped darkness or shadow in the temporal field of vision. This condition occurs after uneventful cataract surgery with an in-the-bag intraocular lens (IOL). To address this issue, supplementary implantation of conventional three-piece IOLs in the sulcus or dedicated supplementary Rayner Sulcoflex(®) IOL have been used successfully. The aim of this retrospective case series was to assess the effectiveness of resolving ND using a supplementary 1stQ AddOn(®) (Medicontur) IOL. The 1stQ AddOn(®) has a different design and optic size compared to the Rayner Sulcoflex(®). Patients experiencing severe and persistent ND underwent supplementary implantation of the 1stQ AddOn(®) IOL. The primary outcome measure was the resolution of dysphotopsia. Nine eyes received the 1stQ AddOn(®) IOL, with complete symptom resolution observed in 6 eyes, partial improvement in 1 eye, and no change in 2 eyes. This indicates that supplementary implantation of the 1stQ AddOn(®) IOL can effectively and safely treat ND, performing equally well as the Rayner Sulcoflex(®). The positive impact of sulcus-fixated supplementary IOLs seems to be related to the interaction between the central optic and the pupil margin.