Visual complaints associated with the AcrySof acrylic intraocular lens

Purpose: To describe the visual complaints of a series of patients implanted with the AcrySof(R) (Alcon Surgical) acrylic intraocular lens (IOL) that resolved with IOL exchange. Setting: Jules Stein Eye Institute, Los Angeles, California and John A. Moran Eye Center, Salt Lake City, Utah, USA. Methods: This was a retrospective review of patients who had AcrySof IOL exchange from January 1997 to December 1998. Results: Eight patients (9 eyes) with bothersome visual symptoms following AcrySof IOL implantation were identified. Problems included glare, halos around point light sources, and peripheral arcs of light, often worse at night. In each case, the IOL was well-centered in the capsular bag and there was no significant posterior capsule opacification. Six patients (7 eyes) had the MA30BA model with a 5.5 mm optic, and 2 patients (2 eyes) had the MA60BM model with a 6.0 mm optic. No extralenticular reasons for the patients' complaints could be identified. Exchanging the AcrySof IOLs with silicone or poly(methyl methacrylate) IOLs alleviated most symptoms. In 5 of 8 patients, dysphotopsias resolved completely. Conclusions: A small number of patients implanted with AcrySof IOLs have specific complaints of glare, halos, and peripheral arcs of light. Optical considerations that may help explain these symptoms include the high refractive index of the IOL material and the truncated design of the optic. Patients who are highly observant and those with large pupils may be particularly symptomatic. Intraocular lens exchange may be necessary in some cases. (C) 2000 ASCRS and ESCRS.