Prediction of IOL decentration, tilt and axial position using anterior segment OCT data

Abstract

Background Intraocular lenses (IOLs) require proper positioning in the eye to provide good imaging performance. This is especially important for premium IOLs. The purpose of this study was to develop prediction models for estimating IOL decentration, tilt and the axial IOL equator position (IOLEQ) based on preoperative biometric and tomographic measures. Methods Based on a dataset (N = 250) containing preoperative IOLMaster 700 and pre-/postoperative Casia2 measurements from a cataractous population, we implemented shallow feedforward neural networks and multilinear regression models to predict the IOL decentration, tilt and IOLEQ from the preoperative biometric and tomography measures. After identifying the relevant predictors using a stepwise linear regression approach and training of the models (150 training and 50 validation data points), the performance was evaluated using an N = 50 subset of test data. Results In general, all models performed well. Prediction of IOL decentration shows the lowest performance, whereas prediction of IOL tilt and especially IOLEQ showed superior performance. According to the 95% confidence intervals, decentration/tilt/IOLEQ could be predicted within 0.3 mm/1.5°/0.3 mm. The neural network performed slightly better compared to the regression, but without significance for decentration and tilt. Conclusion Neural network or linear regression-based prediction models for IOL decentration, tilt and axial lens position could be used for modern IOL power calculation schemes dealing with ‘real’ IOL positions and for indications for premium lenses, for which misplacement is known to induce photic effects and image distortion.

Novel diagnostic indicators for acute angle closure secondary to lens subluxation based on anterior segment and lens parameters

“…It could also be applied to assess the anterior chamber inflammation with higher resolution images [ 23 , 24 ]. Besides, it has been reported to predict IOL tilt and decentration in modern cataract surgery [ 25 ]. While this merit has not been widely used in clinical management.…”

Intraocular lens power calculation formulas: a scientometric analysis

“…Authors in the dark orange cluster shared a common interest in optical coherence tomography [ 38 , 39 ] . Interestingly, Nora Szentmary and Achim Langenbucher collaborated on several articles within this theme [ 39 , 40 ] , potentially attributable to a shared institutional affiliation. Meanwhile, the light orange cluster focused on assessing the accuracy of different IOL power calculation formulas [ 41 , 42 ] .…”

Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography

“…Advancements in imaging technologies, such as swept-source optical coherence tomography ( S S-OCT) and 3D OCT image reconstruction, have enabled more accurate assessment and automated quantification of IOL tilt and decentration [ 6 , [12] , [13] , [14] , [15] ]. This facilitates a comprehensive understanding of the spatial relationship between the IOL and the capsular bag, consequently facilitating a deeper exploration of the effects of postoperative decentration and tilt on visual acuity, dysphotopsia, and wavefront aberrations [ [16] , [17] , [18] ].…”