Diclofenac was more effective than betamethasone in preventing angiographic CME and BAB disruption after small-incision cataract surgery. Thus, nonsteroidal antiinflammatory agents should be considered for routine treatment of eyes having cataract surgery.
Aim: To investigate the influence of tilt and decentration of scleral-sutured intraocular lenses (IOLs) on ocular higher-order wavefront aberrations. Methods: In 45 eyes of 36 patients who had undergone scleral suture fixation of posterior chamber IOL, tilt and decentration of IOLs were determined by Scheimpflug videophotography, and higher-order aberration for a 4-mm pupil was measured using the Hartmann-Shack aberrometer. In another 100 eyes of 100 patients after standard cataract surgery with posterior chamber IOL implantation, ocular higher-order aberration was measured.Results: In eyes with scleral-sutured IOL, the mean (SD) tilt angle and decentration were 4.43˚(3.02˚) and 0.279 (0.162) mm, respectively. Ocular coma-like aberration in the sutured IOL group was 0.324 (0.170) mm, which was significantly greater than that of the standard cataract surgery group ( Malposition of the IOL comprises decentration and tilt. Although it has been known that decentration of the IOL can cause unwanted optical image or dysphotopsia, 6-10 the influence of major IOL tilting on the optical quality of the eye has never been reported. With expanding indications of cataract surgery, more complicated cases will undergo cataract removal and IOL implantation procedures, which would increase the risk of IOL misalignment after surgery. Patients tend to have longer longevity after surgery, which might further increase the risk of postoperative events. The optical performance of IOLs in the presence of displacement has been an important issue even in modern cataract surgery. [11][12][13][14][15] We conducted the current retrospective study to assess the influence of tilting and decentration of scleral-sutured posterior chamber IOLs on ocular higherorder aberrations.
PATIENTS AND METHODS
PatientsForty five eyes of 36 patients (16 men and 20 women) who had undergone scleral suture fixation of a posterior chamber IOL were included. Their age ranged from 46 to 87 years (mean (standard deviation, SD)) 66.3 (14.2) years). The scleralsutured IOLs were hydrophobic acrylic foldable IOL (MA60AC, AcrySof, Alcon Laboratories, Fort Worth, Texas, USA) in 18 eyes and polymethylmethacrylate IOL in 19 eyes, but details were not available in the remaining 8 eyes. Another 100 eyes of 100 patients (41 men and 59 women) after standard cataract surgery with in-the-bag implantation of hydrophobic acrylic foldable IOL (MA60AC) served as age-matched controls, ranging in age from 48 to 88 years (64.5 (13.5) years). The research protocol had institutional review board approval, and written informed consent was obtained from each patient. The study adhered to the tenets of the Declaration of Helsinki.
ExaminationsIn the scleral-sutured IOL group, tilt and decentration of IOLs as well as higher-order wavefront aberration were measured. In the standard cataract surgery group, higher-order wavefront aberration of the eye was measured.Tilt and decentration of IOLs were determined by an anterior eye segment analysis system (EAS-1000; NIDEK, Gamagori, Aichi, Japan).
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