Evaluation of Tilt and Decentration of Intraocular Lens After Combined Femtosecond Laser-Assisted Cataract Surgery...

To evaluate the changes in tilt and decentration prior to and following microincision vitrectomy and femtosecond laser-assisted cataract surgery (FLACS) using a 7 mm intraocular lens (IOL).

Patients were grouped by surgical method: conventional phacoemulsification surgery and vitrectomy without gas (Group A: 27 eyes), conventional phacoemulsification surgery and vitrectomy with gas (Group B: 72 eyes), FLACS and vitrectomy without gas (Group C: 29 eyes), and FLACS and vitrectomy with gas (Group D: 25 eyes). In the femtosecond-laser group, a 5.6 mm capsulotomy was created. 7 mm IOL was inserted in all cases. IOL tilt and decentration were compared using swept-source anterior segment optical coherence tomography for up to 12 months postoperatively.

On postoperative Day 1, the IOL tilt increased in all groups compared to the preoperative values, with a significantly greater increase observed in Groups B and D. Moreover, in Groups B and D, the tilt decreased substantially after Day 1 and gradually declined at 12 months. Similarly, Groups A and C also showed a decrease in tilt after Day 1, with a gradual decline at 12 months. Groups B and D showed greater initial decentration, which decreased over time. In contrast, Groups A and C exhibited more stable decentration values throughout the follow-up period.

In combined cataract surgery and vitrectomy, no difference was observed in the tilt and decentration of the 7 mm IOL between 5.6 mm anterior capsulotomy created by FLACS and continuous curvilinear capsulorhexis, regardless of gas tamponade. Combining FLACS with vitrectomy is an equivalent technique when combined with conventional phacoemulsification surgery and vitrectomy is performed.