Comparison Of Ocular Wavefront Aberrations And Lens Position In Different Secondary Intraocular Lens Implantation Techniques

To compare the effects of different secondary intraocular lens (IOL) implantation techniques on tilt, decentration, and wavefront aberrations.

Marmara University School of Medicine, Department of Ophthalmology

A total of 62 patients (64 eyes) who underwent sulcus implantation (SI), transscleral sutured fixation (TSSF), or sutureless intrascleral fixation (ISSF) were retrospectively evaluated. Clinical data, demographics, uncorrected distance visual acuity (UDVA) and, best-corrected distance visual acuity (CDVA) were assessed. Postoperative lenticular aberration, corneal aberration, total higher-order aberrations (HOAs), modulation transfer function (MTF), and optical dysphotopsia were measured using iTrace aberrometry at the final follow-up. Decentration and tilt were analyzed with CorelDRAW software using the Scheimpflug images. Horizontal/vertical decentration and, horizontal/vertical tilt were determined based on the X and Y axis coordinates.

The study included 21 eyes in the SI group, 27 eyes in the TSSF group, and 16 eyes in the ISSF group. The mean follow-up duration was 3.55±2.06 years, with no significant difference among groups (p=0.058). Preoperative and postoperative UDVA and CDVA were similar between groups (p>0.05), with all groups showing significant postoperative improvement (p<0.05). Lenticular aberrations and total HOAs were similar across groups. Corneal horizontal astigmatism was significantly higher in the TSSF group (-0.67±0.88 μm, p<0.001). Mean MTF and optical dysphotopsia showed no significant differences among groups (p>0.05). Decentration and tilt measurements were comparable across all groups (p>0.05).

Different secondary IOL implantation techniques provided similar outcomes in lens position and visual quality, while corneal astigmatism values were higher in the TSSF group.