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These two occurrences are independent of each other.1,2,8 Despite the resounding success of modern phacoemulsification cataract surgery in terms of visual acuity, the prevalence of the ��20/20 dissatisfied patient�� remains a tangible entity in ophthalmic practices throughout the world. Although a wide array of variables may be contributory, PD is a well-known and important source of visual dissatisfaction. As such, it certainly deserves increased attention in order to help ameliorate this problem. Currently, the ophthalmic industry spends enormous resources in the perfection of pre-operative biometry or determination of accurate cylinder and sphere measurements; yet it has been shown that the degree of PD is actually what optimally correlates with a patient��s overall visual satisfaction and function in uncomplicated surgical cases without confounding pathology and with good visual acuity.1,2 Imperfections in the optical properties of the IOL implant have been implicated in the production of dysphotopsias.4 Others have assessed aspects of lens properties and design that contribute to the production of PD.3,5,6,9�C14 Various studies have demonstrated that IOL edge design certainly impacts the problem.3,5,6,12�C14 Another property of IOL design, specifically refractive index, remains controversial as to its impact on the formation of PDs. One study in particular strongly suggested that increasing refractive index increases PD.13 As with many extant publications on the subject, this previous study suffered from confounders that could impact patient satisfaction reports. This study examined PD and how it correlated with visual satisfaction and function in patients who previously had undergone uncomplicated cataract surgery, using one of two study IOLs that mainly differed by refractive index. Both the SN60WF and the ZCB00 cohorts had documented excellent outcomes as measured by BCVA, and both cohorts were screened for any confounding diseases or surgical complications to the extent that this is allobarbital possible in a chart review. We sought to demonstrate the difference, if any, in the incidence of PD complaints and satisfaction in patients with a higher refractive index IOL (1.55) versus those with a lower refractive index IOL (1.47). Though other IOL parameters such as overall and edge design are known to impact the problem of PD, the impact of refractive index has remained controversial. This had been poorly studied to date in a clinical setting, although a study which looked at laser ray tracing indicated that the problem should positively correlate with refractive index.