Objective evaluation of negative dysphotopsia with Goldmann kinetic perimetry

PURPOSE: To compare the extension of peripheral visual fields in phakic and pseudophakic patients and to evaluate whether Goldmann kinetic perimetry can be used as an objective measure of negative dysphotopsia. SETTING: University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands. DESIGN: Prospective and case-control study. METHODS: Kinetic perimetry was performed with V4e and 14e stimuli. Visual fields were assessed in the following 4 quadrants: superior temporal, superior nasal, inferior temporal, and inferior nasal. In the control group, patients were evaluated before and 1 month after cataract surgery. Biometric and perimetric data in the control group were compared with data in the patients with negative dysphotopsia (study group). RESULTS: Each group comprised 10 patients. In the control group, the extension of visual field did not change after surgery. Patients in the study group had a significantly shorter axial length and higher intraocular lens powers than those in the control group. The inferior temporal and inferior nasal quadrants were, respectively, 10 degrees and 6 degrees (P <.05) smaller in the study group than in the control group. In 3 patients with negative dysphotopsia, a shadow was drawn in the superior temporal and the inferior temporal quadrants during perimetry and the position of this shadow matched their subjective description of negative dysphotopsia. CONCLUSIONS: The peripheral visual field did not change after cataract surgery in patients without negative dysphotopsia. Kinetic perimetry can be used for objective evaluation of patients with negative dysphotopsia because these patients had constricted peripheral visual fields or a relative temporal scotoma corresponding to the position of the shadow.