The Influence Of Decentration And Tilt On Astigmatism And Higher Order Aberrations In Scleral Fixated Iols
Published 2023 - 41st Congress of the ESCRS
Reference: PP19.07 | Type: Free paper | DOI: 10.82333/6yr9-n520
Authors: Markus Schranz* 1 , Adrian Reumüller 1 , Victor Danzinger 1 , Marcus Lisy 1 , Daniel Schartmüller 1 , Christina Leydolt 1 , Claudette Abela-Formanek 1
1Ophthalmology and Optometry,Medical University of Vienna,Vienna,Austria
Purpose
To evaluate the influence of decentration and tilt on astigmatism and higher order aberration in eyes who underwent scleral fixated intraocular lens implantation.
Setting
Department for Ophthalmology and Optometry, Medical University of Vienna, Austria
This prospective single surgeon follow-up study involved Patients who underwent intrascleral IOL implantation using the Carlevale (Carlevale SSF6 IOL, Soleko), Yamane (Aspira 3PAva, Human Optics) and 4 flanged technique (Micropure, Physiol) due to IOL dislocation, complicated cataract surgery or trauma resulting in aphakia.
Methods
Patients were evaluated for their postoperative best corrected visual acuity (VA), IOL decentration & tilt as well as for inner higher order aberrations (iHOA).
To image decentration and tilt an anterior segment optical coherence tomograph (Casia 2, Tomey) was used. To evaluate higher order aberrations a topograph/aberrometer device (Peramis, Schwind) was used, and the pupil size was set to 4.5mm.
Imaging was performed 30 minutes after pupil dilation, correct head alignment was crucial.
A mixed model was calculated to evaluate the correlations between inner astigmatism, iHOA, respectively, and tilt, decentration, lens power, surgery method (lens type) and axial length.
Results
A total of 31 eyes of 31 patients were evaluated consisting of 11 Carlevale and 20 four-flanged technique. Mean IOL tilt was 6.8°±2.3° (range:2.9-12.4), mean decentration was 0.40mm±0.21 (range:0.09-0.86), mean inner astigmatism was 0.71D±0.69 (range:0-3.9), mean iHOA were 0.29±0.15RMS (range:0.14-0.79).
Using a mixed model, we did not find any significant correlation between inner astigmatism and IOL tilt (p=0.54) and decentration (p=0.27).
Evaluating the correlations between iHOAs and the previous parameters a similar also non-significant result was obtained.
Conclusions
Within our study population the given amounts of decentration and tilt had no significant influence on inner astigmatism or iHOAs, showing that a mean decentration of 0.4mm and a mean tilt of 7° is well tolerated and bears no negative effect on visual acuity for the patient.