New approach for treating vertical strabismus: decentered intraocular lenses

To evaluate a new surgical procedure that uses a decentered intraocular lens (IOL) to correct vertical strabismus in cataract patients.

Department of Ophthalmology, Kitasato University School of Medicine, Sagamihara, Japan.

Six patients (11 eyes) with vertical strabismus had small-incision cataract surgery. The continuous curvilinear capsulorhexis was decentered, and the asymmetrical span of the IOL haptics located on the side to be bent was inserted after phacoemulsification and aspiration. Some relaxing incisions were made in the anterior capsule. Postoperatively, the alternate prism cover test was used to assess changes in ocular position. In addition, the EAS-1000 (Nidek) and KR-9000PW (Topcon) were used to evaluate IOL decentration, tilt, and aberrations.

The mean age of the patients was 66 years (range 58 to 77 years). The mean preoperative vertical strabismus was 7.3 prism diopters (PD) (range 4 to 12 PD). Two years after surgery, the mean angle of vertical deviation was 1.3 PD (range 0 to 5 PD) without affectivity coma-like aberrations (S3). The mean amount of decentration was 0.52 mm +/- 0.29 (SD) and the mean tilt, 4.30 +/- 2.85 degrees (n = 10 eyes).

Decentered IOL implantation was effective in cataract patients with vertical strabismus and can be performed during cataract surgery.