Quantification of physiological crystalline Lens decentration using swept source OCT

PurposeTo quantify the decentration of the crystalline lens in a large Austrian adult cataractous and non-cataractous cohort and to predict decentration using biometric parameters.SettingKepler University Clinic, Linz, Austria.DesignRetrospective single-center study.MethodsPreoperative data sets from a cataractous population acquired between 2020 and 2022 were analyzed in this study. Measurements included optical biometry (IOLMaster 700, Carl Zeiss Meditec AG, Germany) as well as anterior segment optical coherence tomography (CASIA-2, Tomey, Japan). Both individual and bilateral analysis of decentration was performed. For decentration prediction, a machine learning algorithm (random forest) was implemented.ResultsIn total, 4731 eyes of 2531 patients were included in this study. Overall mean decentration was 0.212 mm; 95% CI: 0.208-0.216 mm, with 5.3% of patients exceeding a decentration amount of 0.4 mm. There was a low but significant correlation with tilt (r2 = 0.29; p < 0.01), CW (r2 = 0.28; p < 0.001), lens diameter (r2 = 0.09; p < 0.001) and ACD (r2 = 0.09; p < 0.001).ConclusionA decentration amount <0.3 mm should be considered physiological.The preoperative assessment of physiological decentration and its relationship with other biometric parameters could aid in the improvement of postoperative refractive outcomes and patient satisfaction, especially in selecting premium intraocular lenses.