IOL tilt and decentration: a comparison of different haptic designs using CNN and SS-OCT in a short term

To investigate the tilt and decentration differences and influencing factors of intraocular lenses (IOLs) with plate-haptic and C-loop haptic designs one month after cataract surgery, using the combination of swept-source optical coherence tomography (SS-OCT) and a customized convolutional neural network (CNN) algorithm.

Participants were categorized into two groups based on the haptic design of their implanted IOLs. Group A included 37 patients (37 eyes) with the ATTORBI 709 M plate-haptic design, while Group B comprised 42 patients (42 eyes) with the PY-60 AD C-loop design. SS-OCT examinations were performed both before and one month after cataract surgery. A customized CNN algorithm was developed to generate data for IOL tilt and decentration, using the corneal vertex as a reference.

This study included 79 patients (79 eyes). Before surgery, there were no statistically significant differences in ocular parameters between the two groups (all p > 0.05). Significant difference in IOL decentration was observed (Group A & Group B: 0.16 ± 0.08 mm & 0.42 ± 0.28 mm, p < 0.001). In contrast, the difference in IOL tilt was not significant (Group A & Group B: 4.60 ± 1.27° & 4.63 ± 1.93°, p = 0.948). Both groups displayed a predominant inferotemporal tilt of the crystalline lens and IOL, but decentration did not show a distinct distribution pattern. Multivariate linear regression confirmed a correlation between IOL tilt in both groups and crystalline lens tilt (p < 0.003).

The plate-haptic design IOL shows less decentration than the C-loop design. Clinicians should consider this potential difference in IOL stability when selecting IOLs with varying haptic designs.