ESCRS - PO342 - Evaluation Of Tilt And Decentration Of The Crystalline Lens And Intraocular Lens Following Femtosecond Laser-Assisted Cataract Surgery

Evaluation Of Tilt And Decentration Of The Crystalline Lens And Intraocular Lens Following Femtosecond Laser-Assisted Cataract Surgery

Published 2025 - 43rd Congress of the ESCRS

Reference: PO342 | Type: Free paper | DOI: 10.82333/sjv1-qw92

Authors: Robert Edward Ang* 1

1Cornea and Refractive Surgery,Asian Eye Institute,Makati,Philippines

Purpose

To evaluate crystalline lens (CL) and intraocular lens (IOL) tilt and decentration following uneventful femtosecond laser-assisted cataract surgery (FLACS) in a cohort of Caucasian eyes using CASIA2 Advanced (Tomey) anterior segment optical coherence tomography (AS-OCT).

Setting

Clinica Miranza Madrid, Spain.

Methods

This was a prospective, observational, non-randomized, single-center study. CL tilt and decentration, as well as postoperative IOL tilt and decentration, were assessed in eyes undergoing uneventful FLACS for cataracts or refractive lens exchange. Patients with systemic or ocular conditions affecting capsular bag stability, or those with poorly dilating pupils preventing femtosecond laser-assisted standardized 5.0 mm capsulorhexis, were excluded. Tilt and decentration measurements were obtained using the Lens Analysis software integrated into the CASIA 2 system. Univariate and multivariate regression analyses were performed to assess associations between ocular biometric parameters and tilt and decentration of both CL and IOL.

Results

The study included 125 consecutive eyes from 125 patients. The median age was 71 years (41 to 88 years). Preoperative CL tilt and decentration were 5.20 ± 1.35 degrees and 0.16 ± 0.09 mm, respectively. At 1 month postoperatively, mean IOL tilt was 5.08 ± 1.33 degrees, and IOL decentration was 0.23 ± 0.12 mm, measured from the corneal topographic axis under nonmydriatic conditions. Age and axial length (AL) were significant predictors of CL decentration, with older patients and those with longer eyes showing less decentration. CL tilt was significantly correlated with AL. IOL tilt was predicted by AL and IOL power, with larger IOL powers associated with reduced tilt. IOL decentration was inversely related to age and differed by IOL brand.

Conclusions

Following uneventful FLACS, IOLs tend to be inferotemporally tilted relative to the corneal topographic axis and slightly temporally decentered. These findings align with preoperative CL measurements. These parameters can be easily assessed using AS-OCT integrated software. Several predictor variables, including age, AL, and IOL power, are associated with tilt and decentration of both CL and IOL.