Influence of tilt and decentration of scleral-sutured intraocular lens on ocular higher-order wavefront aberration

Abstract

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). ...

Scleral fixation technique using a hydrophobic foldable intraocular lens with ring-shaped connecting bridges

“…Discordance between the 2 positions might cause IOL tilting or decentration due to IOL deformity. 13 The conventional method (suturing at the haptic) is usually promising but could produce a gap between the haptic and the sulcus area, leading to IOL tilting in a rare case of ciliary body atrophy.…”

Effect of trabeculectomy on ocular and corneal higher order aberrations

“…Studies utilizing recent wavefront technology have found that ocular surgeries increase the incidence of ocular and corneal higher order aberrations, thereby affecting postoperative visual function [14][15][16][17][18][19]. Thus, a good understanding of the effect of ocular surgeries on ocular and corneal higher order aberrations is clinically important.…”

“…Patients sometimes complain of changes in vision after trabeculectomy, but the mechanisms of these changes are not fully understood. On the other hand, recent advances in wavefront technology have revealed that ocular surgeries, such as corneal transplantation [14][15][16], intraocular lens implantation [17], scleral buckling surgery [18], and pterygium surgery [19], increase ocular and/or corneal higher order aberrations, thereby affecting postoperative visual function. It is thus evident that a thorough understanding of the effect of ocular surgeries on ocular and corneal higher order aberrations is clinically important.…”

Visual simulation through different intraocular lenses using adaptive optics: Effect of tilt and decentration

“…Subjects performed visual acuity tests using these wavefront patterns. The amounts of decentration and tilt chosen for this study were based on Eppig et al, 11 who analyzed clinical studies [25][26][27][28][29][30][31][32][33][34][35] that evaluated IOL decentration and after cataract surgery. The authors found that in general, the mean decentration in the studies was 0.30 G 0.16 mm and the mean tilt was 2.62 G 1.14 degrees.…”