Surgical approach affects intraocular lens decentration

Area of Science:

• Ophthalmology
• Surgical Innovation
• Medical Imaging

Background:

• Intraocular lens (IOL) tilt and decentration can affect visual outcomes after cataract surgery.
• Accurate quantification of IOL position is crucial for assessing surgical success.
• Scheimpflug imaging offers a precise method for evaluating IOL alignment.

Purpose of the Study:

• To quantify intraocular lens (IOL) tilt and decentration in the early postoperative period.
• To identify risk factors, specifically surgical approach, for IOL displacement.
• To assess the utility of Scheimpflug imaging in evaluating IOL position.

Main Methods:

• Prospective study of 268 eyes undergoing cataract surgery with one-piece IOL implantation.
• Evaluation of IOL tilt and decentration using Scheimpflug imaging at 1 week, 1 month, and 3 months.
• Comparison of IOL positions between superior and temporal surgical approaches; correlation with age and axial length.

Main Results:

• Average IOL displacement was 150 μm upward and 150 μm nasally.
• Over 50% of eyes showed upward tilt, and 90% temporal tilt.
• Surgical approach significantly affected horizontal decentration and, in right eyes, vertical decentration at 1 week; age and axial length were not associated with IOL position.

Conclusions:

• Scheimpflug imaging is a reliable quantitative tool for assessing IOL position.
• The surgical incision site significantly influences early postoperative IOL position, particularly at 1 week.
• Early postoperative IOL alignment is primarily determined by surgical approach rather than patient biometry.