Surgical approach affects intraocular lens decentration

• Published in: Journal of the Formosan Medical Association 2017-03, Vol.116 (3), p.177-184
• Main Authors: Chang, Pei-Yao, Lian, Chi-Yang, Wang, Jia-Kang, Su, Pei-Yuan, Wang, Jiun-Yi, Chang, Shu-Wen
• Format: Article
• Language: English
• Subjects: Aged; Artificial Lens Implant Migration - diagnostic imaging; Female; Humans; Internal Medicine; intraocular lens decentration; intraocular lens position; Lenses, Intraocular; Male; Middle Aged; Multivariate Analysis; Phacoemulsification - methods; Photography; Postoperative Complications - diagnostic imaging; Prospective Studies; Regression Analysis; Risk Factors; Scheimpflug imaging; Taiwan; Visual Acuity - physiology
• ISSN: 0929-6646; 1876-0821
• DOI: 10.1016/j.jfma.2016.04.003

Purpose This study aims to quantify and identify risk factors for intraocular lens (IOL) tilt and decentration early after surgery using Scheimpflug imaging. Methods We prospectively included 268 eyes of 253 patients who underwent uneventful cataract surgery and one-piece IOL implantation using a superior or temporal approach. Scheimpflug imaging was used to evaluate the tilt and decentration of IOLs at 1 week, 1 month, and 3 months postoperatively. Differences in IOL tilt and decentration between the approaches were examined. Correlations of age and axial length with the magnitudes of IOL decentration and tilt were also examined. Results In total, 139 right and 129 left eyes were included. IOL displacement averaged 150 μm upward and 150 μm to the nasal side of the pupil. Over 50% of the eyes were tilted upward and approximately 90% to the temporal side. The surgical approach was significantly associated with horizontal decentration in both eyes, but significantly associated with only vertical decentration in the right eye 1 week postoperatively. In the left eyes, IOLs were shifted to the nasal side in 57.1% and 36.8% of the eyes that received the temporal and the superior approach, respectively, compared with 75.8% and 50% in the right eyes. The differences were significant only at 1-week follow-up ( p  = 0.035 and p  = 0.003, respectively). Age or axial length was not associated with IOL tilt or decentration in either eye. Conclusion Scheimpflug imaging can be used as a quantitative tool to evaluate IOL position. The incision site affected the IOL position, this finding was significant at 1 week postoperatively only.