IOL STABILITY ACROSS THE AXIAL LENGTH SPECTRUM: COMPARISON AND BIOMETRIC PREDICTORS OF TILT AND DECENTRATION IN SHORT, NORMAL AND LONG EYES
Published 2026 - 30th ESCRS Winter Meeting
Reference: FP02.04 | Type: Free Paper | DOI: 10.82333/a71g-9r50
Authors: Klaus Straßmair* 1 , Sophia Reifeltshammer 1 , Leon Pomberger 1 , Klemens Waser 1 , Matthias Bolz 1 , Nino Hirnschall 1
1Department of Ophthalmology,Kepler University Clinic,Linz,Austria;Department of Ophthalmology,Johannes Kepler University,Linz,Austria
Purpose
To measure and compare intraocular lens (IOL) tilt, decentration and anterior chamber depth (ACD) across eyes with short, normal and long axial lengths (AL) and to identify biometric predictors of these outcomes.
Setting
Department of Ophthalmology, Kepler University Clinic and Johannes Kepler University, Linz, Austria.
Methods
This prospective, single-center study included patients scheduled for bilateral cataract surgery and grouped the study eyes into three axial length cohorts: short (AL < 22.75 mm), normal (AL 22.75–25.50 mm) and long (AL > 25.50 mm). Examinations were performed preoperatively and at 1 and 12 weeks postoperatively. Study examinations included optical biometry (IOLMaster 700, Carl Zeiss Meditec, Germany) and anterior segment optical coherence tomography (CASIA2, Tomey, Japan). Furthermore, autorefraction, subjective refraction, monocular corrected distance visual acuity (CDVA) and monocular distance-corrected intermediate visual acuity (DCIVA) were assessed. In all cases, the Clareon CNA0T0 IOL (Alcon, USA) was implanted.
Results
A total of 131 eyes (21 short, 98 normal, 12 long) of 81 patients were included in the study. Mean age was 70.36 ± 10.41 years. Preoperative ACD was 3.00 ± 0.32 mm in short, 3.10 ± 0.38 mm in normal and 3.59 ± 0.22 mm in long eyes. Preoperative tilt was 5.78 ± 1.37°, 4.77 ± 1.51° and 4.61 ± 2.21°, respectively. Preoperative decentration was 0.13 ± 0.08 mm, 0.16 ± 0.08 mm and 0.13 ± 0.07 mm, respectively. At the 12-week follow-up, postoperative ACD was 4.47 ± 0.24 mm in short, 4.69 ± 0.34 mm in normal and 5.07 ± 0.19 mm in long eyes. Postoperative tilt was 6.04 ± 1.58°, 5.06 ± 1.41° and 4.65 ± 1.28°, respectively. Postoperative decentration was 0.22 ± 0.12 mm, 0.26 ± 0.13 mm and 0.19 ± 0.14 mm, respectively.
Conclusion
The Clareon IOL demonstrated stable positioning within the capsular bag across different axial lengths with minimal changes in tilt and decentration after cataract surgery. The final analysis, including biometric predictors, will be presented at the ESCRS Congress in Helsinki.