Impact of vitrectomy and air tamponade on aspheric intraocular lens tilt and decentration and ocular higher-order aberrations: phacovitrectomy versus cataract surgery

• Published in: Japanese journal of ophthalmology 2020-07, Vol.64 (4), p.359-366
• Main Authors: Iwama, Yasuaki, Maeda, Naoyuki, Ikeda, Toshihide, Nakashima, Hiroshi, Emi, Kazuyuki
• Format: Article
• Language: English
• Subjects: Cataracts; Clinical Investigation; Eye (anatomy); Eye surgery; Intraocular lenses; Medicine; Medicine & Public Health; Ophthalmology; Subgroups; Surgery; Tamponade
• ISSN: 0021-5155; 1613-2246
• DOI: 10.1007/s10384-020-00737-0

Purpose To evaluate the impact of vitrectomy and air tamponade on aspheric intraocular lens (IOL) tilt and decentration and postoperative internal higher-order aberrations (HOAs) in combined cataract surgery and vitrectomy (phacovitrectomy). Study design Prospective comparative observational study. Methods Forty-five eyes that underwent phacovitrectomy using aspheric IOLs and 18 eyes that only underwent cataract surgery also using aspheric IOLs were prospectively evaluated. The subjects were divided into three groups: phacovitrectomy without fluid-air exchange (F/Ax) or with F/Ax and cataract surgery alone (Groups A, B, and C, respectively) Surgery-induced changes in lens tilt and decentration and internal HOAs were compared between each pair of groups. Subgroup analysis was conducted for cases with largely tilted (> 7°) or decentered (> 0.40 mm) IOLs 1 month postoperatively. Results Surgery-induced changes in lens tilt in Group B were significantly more pronounced than those in Group C at 1 week, 1 month, and 3 months postoperatively ( P = 0.007, 0.009, and 0.043, respectively), while there was no significant difference in surgery-induced changes in lens decentration among the groups. IOLs in Group B were tilted and decentered toward the inferonasal direction. In contrast, there was no significant difference in internal HOAs among the groups at any postoperative visit. Only Group B included cases with largely decentered IOLs, and the internal total HOAs in these cases were significantly larger than those in the others ( P = 0.015). Conclusion Although largely decentered IOLs were occasionally found in Group B, aspheric IOLs could be effectively used in phacovitrectomy.