Intraocular Lens Tilt And Decentration After Primary And Delayed Implantation In Phacovitrectomy For Rhegmatogenous Retinal Detachment Repair

To evaluate the tilt and decentration of intraocular lenses (IOLs) in eyes that underwent phacovitrectomy for rhegmatogenous retinal detachment (RRD) repair.

This study was conducted in Aier Eye Hospital Group Co. Ltd. All study procedures were performed in accordance with the tenets of the Declaration of Helsinki and its amendments. The ethics committee of Aier Eye Hospital Group Co. Ltd. approved this study.

In this retrospective cohort study, 63 patients with RRD who underwent phacovitrectomy in the past five years were enrolled and divided into a primary implantation group (Group A) and a delayed implantation group (Group B) according to the time of IOL implantation. Routine ocular examinations, including optometry, were performed, and the IOL tilt and decentration were measured using swept-source anterior segment optical coherence tomography. Postoperative refractive prediction error, IOL tilt and decentration were compared between the two groups, and the relevant factors of IOL positions were analyzed.

The mean spherical refractive prediction error (MSE) was -0.53±0.39 D in Group A, while that in Group B was -0.09±0.55. The mean absolute spherical refractive prediction error (MASE) was 0.61±0.23 D in Group A and 0.50±0.22 D in Group B. The difference in MSE (t=-3.623, p<0.05) but not in MASE (t=1.866, p=0.067) between the two groups was significant. In Group A, the mean IOL tilt was 8.54±3.65°, and the mean decentration was 0.55±0.18 mm. Those in Group B were 10.62±3.29° and 0.66±0.14 mm. Differences in both tilt and decentration between the two groups were significant (p<0.05). In Group B,  the absolute values of IOL tilt and decentration were positively correlated with the mean time interval between phacovitrectomy and IOL implantation.

In phacovitrectomy for RRD repair, primary IOL implantation leads to a postoperative myopic shift, while delayed IOL implantation may cause greater IOL tilt and decentration.