Quantification Of Physiological Tilt Of The Phakic Eye Using Longitudinal And High Resolution Swept Source Optical Coherence Tomography

To comprehensively evaluate the tilt of the crystalline lens in phakic eyes and its relationship with optical biometry parameters. Setting: The retrospective analysis was conducted at the Department for Ophthalmology and Optometry, Kepler University Clinic in Linz, Austria. Design: Retrospective observational case series without randomization or masking. Lens tilt was assessed using swept-source optical coherence tomography (SS-OCT) data.

The retrospective analysis was conducted at the Department for Ophthalmology and Optometry, Kepler University Clinic in Linz, Austria.

The study analyzed preoperative SS-OCT images from 4731 eyes of 2531 patients prior to cataract surgery. The optical biometry parameters were correlated with the degree of lens tilt using logistic regression and machine learning techniques.

The average lens tilt was 4.9°, with 8.3% of eyes showing a tilt greater than 7°. Significant associations were found with specific biometry parameters, such as anterior chamber depth (ACD), axial length (AL), equator thickness and lens decentration. The developed predictive model for assessing tilt risk demonstrated a high accuracy with an area under the curve of 0.862. Eyes with history of previous surgery, ocular trauma or pseudoexfoliation syndrome, showed a higher incidence of significant lens tilt.

The findings highlight the average lens tilt of 4.9° in a cataract patient cohort, emphasizing the need for precise assessment of lens tilt for accurate intraocular lens power calculations and optimal postoperative visual outcomes. The study confirms that the crystalline lens tilt has a significant impact on the effective lens position and should be a key consideration in preoperative planning for cataract surgery.