Purpose: To analyze the characteristics and factors associated with intraocular lens (IOL) tilt and decentration after uneventful phacoemulsification with IOL implantation. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Cross-sectional study. Methods: All patients underwent a general ophthalmologic examination and anterior segment photography. IOL tilt and decentration were measured with a second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were performed to assess the association between IOL tilt and decentration with ocular biometric and systemic parameters, and the visual acuity. Results: A total of 196 eyes of 196 patients were enrolled in this study. IOLs showed a mean tilt of 4.8 degrees toward the inferotemporal direction, and the mean decentration was 0.21 mm. Both eyes presented a mirror symmetry relationship. Twenty-two eyes (11.22%) had a tilt greater than 7 degrees, and 21 eyes (10.72%) had a decentration more than 0.4 mm. Multivariate regression analysis showed previous pars plana vitrectomy (PPV) and short axial length (AL) were associated with greater IOL tilt (P = .014 and P < .001). In addition, long AL, thicker lens, and less capsulorhexis–IOL overlap were positively correlated with decentration (P < .001, P = .029, and P = .026). Corrected distance visual acuity did not directly correlate with IOL tilt and decentration (P = .417 and P = .550). Conclusions: PPV history and short AL were associated with greater IOL tilt, whereas longer AL, thicker lens, and overlarge capsulorhexis contribute to greater decentration. Implantation of toric and multifocal IOLs in these patients should be cautious.

Super formula (LSF), and Emmetropia Verifying Optical formulas in highly myopic eyes.DESIGN: Retrospective, consecutive case-series study. METHODS: A total of 164 eyes of 164 patients with AL ‡26.0 mm were included and divided into 2 groups: AL <28.0 mm (Group 1) and AL ‡28.0 mm (Group 2). The average arithmetic spherical equivalent prediction error (PE), mean absolute PE, median absolute error (MedAE), and the percentage of eyes within ±0.25 diopter (D), ±0.50 D, and ±1.0 D of PE were determined. RESULTS: The Holladay 1 formulas showed the smallest MedAE when combined with the first linear or nonlinear version of Wang-Koch AL adjustment methods, both in total and in subgroups. The SRK/T formula displayed the highest prediction accuracy in combination with the first linear version of Wang-Koch adjustment method in total and subgroups. The CMAL reduced the absolute PE of LSF in total (P [ .003) and in Group 1 (P [ .017).CONCLUSIONS: The Holladay 1 and SRK/T formulas combined with specific AL adjustment methods had accuracy similar to the fourth-generation formulas for highly myopic eyes. Moreover, the CMAL can improve the accuracy of the LSF for highly myopic eyes.

Background: To identify the main determinants of intraocular lens (IOL) tilt and decentration after cataract surgery using a novel anterior segment optical coherence tomography (AS-OCT) method.Methods: Fifty-six patients who underwent phacoemulsification with IOL implantation in one eye were continuously enrolled in this cohort study. Axial length (AL) was measured with IOL Master 700. The tilt and decentration of patients' preoperative crystalline lenses and postoperative IOLs, as well as crystalline lens thickness (LT), were measured using AS-OCT before surgery and 1 week after surgery. Results:The mean tilt and decentration of the patients' preoperative crystalline lenses were 4.90°±1.81° and 0.21±0.02 mm, and the mean tilt and decentration of IOLs were 4.75°±1.66° and 0.21±0.02 mm, respectively. There were no significant differences in magnitude, direction of tilt, or decentration between crystalline lenses and IOLs. The strongest determinant of IOL tilt was preoperative crystalline lens tilt (R²=0.512, P<0.001), followed by AL (R²=0.154, P=0.003). Additionally, crystalline lens decentration and AL explained 54.6% of the variability in IOL decentration. AL was the factor most highly associated with IOL decentration (R 2 =0.332, P<0.001), rather than crystalline lens decentration (R 2 =0.214, P<0.001). Conclusions:The position of the preoperative crystalline lens and AL were the critical determinants of IOL tilt and decentration. The tilt and decentration of IOLs will be greater in patients with larger tilt and decentration of crystalline lenses, or shorter and longer AL.