Clinical Impact Of Intraocular Lens Tilt And Decentration On Visual Outcome In Patients Undergoing Cataract Surgery
Published 2024 - 42nd Congress of the ESCRS
Reference: PO334 | Type: Free paper | DOI: 10.82333/yht2-9188
Authors: Lourdes Salgueiro-Tielas* 1 , Laura Moreno-Rodriguez 1 , Azahara Sanchez-Lozano 1 , Luis Garcia-Onrubia 1 , Gonzalo Velarde-Rodriguez 1 , Miguel António Faria-Ribeiro 2 , Nicolas Alejandre-Alba 1
1Ophthalmology,Fundación Jiménez Díaz University Hospital,Madrid,Spain, 2Physics,Universidade do Minho,Braga,Portugal
Purpose
This study aims to evaluate the association between monocular best distance corrected visual acuity (BDCVA) and intraocular lens (IOL) tilt and decentration, at least three months post cataract surgery with a monofocal IOL (Clareon CNA0T0). Additionally, other variables such as distance corrected visual acuity (DCVA), angle kappa in terms Mu chord length (MuC), white-to-white (WTW) diameter, axial length (AL), and capsulorhexis characteristics were assessed to explore their correlation with patient vision and IOL position.
Setting
The study was conducted at the tertiary referral hospital Fundación Jiménez Díaz in Madrid, Spain.
Methods
This cross-sectional study received approval from the institutional ethical board. Inclusion criteria were uneventful cataract surgery with a minimum three-month follow-up, negative history of other ocular comorbidities, an AL between 22- and 26-mm and presurgical astigmatism lower than 1D. BCDVA and DCIVA were measured at 4m and 60cm, respectively, and reported in LogMAR. A capture of the slit lamp examination was taken to evaluate the capsulorhexis. The capsulorhexis area and roundness were assessed using an image software designed for research proposes (ImageJ). Anterior OCT (CASIA II) measurements were used to assess IOL decentration and tilt, and WTW diameter. AL and Mu-chord (MuC) were evaluated with the IOL Master 700.
Results
This study included both eyes from 68 patients, with a mean age of 72.85±9.13 years. The median and [interquartile range] for monocular and binocular BCDVA were 0.00 [0.04] and -0.04 [0.10], respectively. Monocular and binocular DCIVA presented a median of 0.6 [0.25] and 0.48 [0.14], respectively. The median IOL tilt was 5.20 [1.62] °, with a median decentration of 0.23 [0.16] mm. WTW presented a median of 11.28 [0.60] mm, a MuC of 0.36 [0.21]mm and capsulorhexis roundness of 96 [6] %.
Correlation analysis revealed no association between IOL tilt and BCDVA (r=0.04, p=0.56), and IOL tilt and DCIVA (r=-0.14, p=0.09). None of the other variables showed association except for IOL tilt and MuC (r=0.19, p=0,02) and AL (r=-0.38, p<0.001).
Conclusions
IOL tilt did not correlate with BDCVA and DCIVA, suggesting a minimal impact on the patient's corrected far and near visual acuity. Current results suggest good stability of Clareon IOLs, with uniformly low tilt across all patients.