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.