Characteristics and Risk Factors of Intraocular Lens Tilt and Decentration of Phacoemulsification After Pars Plana Vitrectomy

Overview

Journal Transl Vis Sci Technol

Specialties Biomedical Engineering
Ophthalmology

Date 2021 May 18

PMID 34003961

Citations 6

Authors

Xuhua Tan

Zhenzhen Liu

Xiaoyun Chen

Yi Zhu

Jingmin Xu

Xiaozhang Qiu

Guangyao Yang

Lulu Peng

Xiaoxun Gu

Jiaqing Zhang

Lixia Luo

Yizhi Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to investigate the characteristics and risk factors of intraocular lens (IOL) tilt and decentration of phacoemulsification after pars plana vitrectomy (PPV) using swept-source optical coherence tomography (SS-OCT).

Methods: One hundred four eyes with prior PPV and 104 eyes without PPV undergoing uneventful cataract surgery were enrolled in this study. IOL tilt and decentration were measured by SS-OCT (CASIA2) 3 months postoperatively.

Results: The mean IOL tilt and decentration were greater in the PPV group (5.36 ± 2.50 degrees and 0.27 ± 0.17 mm, respectively) than in the non-PPV group (4.54 ± 1.46 degrees, P = 0.005; 0.19 ± 0.12 mm, P < 0.001, respectively). Multiple logistic regression showed that silicone oil (SO) tamponade (odds ratio [OR] = 5.659, P = 0.021) and hydrophilic IOL (OR = 5.309, P = 0.022) were associated with IOL tilt over 7 degrees, and diabetes mellitus (DM; OR = 5.544, P = 0.033) was associated with IOL decentration over 0.4 mm. Duration of SO tamponade was positively correlated with IOL tilt (P = 0.014) and decentration (P < 0.001). The internal total higher-order aberration, coma, trefoil, and secondary astigmatism in the PPV group were higher than in the non-PPV group, and positively correlated with IOL tilt (P < 0.05).

Conclusions: Patients with prior vitrectomy had greater IOL tilt and decentration than the non-PPV group. Longer duration of SO tamponade, hydrophilic IOL, as well as DM were the risk factors of greater IOL tilt and decentration in patients with prior PPV.

Translational Relevance: Optically sophisticated designed IOLs should be used cautiously in vitrectomized eyes.

Citing Articles

Effect of crystalline lens decentration and tilt on visual performance in eyes implanted with bifocal or extended depth of focus intraocular lenses.

Zhang Y, Zhang J, Liang C, Xu Y, Wu J, Wu J BMC Ophthalmol. 2025; 25(1):58.

PMID: 39901088 PMC: 11792569. DOI: 10.1186/s12886-025-03884-5.

Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses.

Li H, Yang F, Zhu Z, Zhao Y, Chang P, Zhao Y Int J Ophthalmol. 2024; 17(12):2321-2326.

PMID: 39697891 PMC: 11589438. DOI: 10.18240/ijo.2024.12.22.

Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography.

Lee Y, Choi H, Bae S, Chung H, Kim J, Lee H Heliyon. 2024; 10(9):e29780.

PMID: 38699005 PMC: 11064088. DOI: 10.1016/j.heliyon.2024.e29780.

Observation on the tilt and decentration of multifocal intraocular lens with optic capture in Berger space for pediatric cataract.

Fan Z, Wang M, Peng Y, Wang X, Li D, Ding Y Int Ophthalmol. 2024; 44(1):203.

PMID: 38671195 DOI: 10.1007/s10792-024-03130-9.

Outcomes of Secondary Intracapsular Intraocular Lens Implantation in Patients following Rhegmatogenous Retinal Detachment.

Wu K, Shi J, Zong Y, Xu G, Zhu H, Jiang C J Clin Med. 2023; 12(24).

PMID: 38137820 PMC: 10743941. DOI: 10.3390/jcm12247749.

References

Montes-Mico R, Lopez-Gil N, Perez-Vives C, Bonaque S, Ferrer-Blasco T . In vitro optical performance of nonrotational symmetric and refractive-diffractive aspheric multifocal intraocular lenses: impact of tilt and decentration. J Cataract Refract Surg. 2012; 38(9):1657-63. DOI: 10.1016/j.jcrs.2012.03.040. View

Eppig T, Scholz K, Loffler A, Messner A, Langenbucher A . Effect of decentration and tilt on the image quality of aspheric intraocular lens designs in a model eye. J Cataract Refract Surg. 2009; 35(6):1091-100. DOI: 10.1016/j.jcrs.2009.01.034. View

Nakano Y, Nomoto H, Fukuda K, Yamaji H, Fujita T, Inoue Y . Combined 25-gauge vitrectomy and cataract surgery with toric intraocular lens with idiopathic epiretinal membrane. J Cataract Refract Surg. 2013; 39(5):686-93. DOI: 10.1016/j.jcrs.2012.11.029. View

Tognetto D, Toto L, Ballone E, Ravalico G . Biocompatibility of hydrophilic intraocular lenses. J Cataract Refract Surg. 2002; 28(4):644-51. DOI: 10.1016/s0886-3350(01)01158-0. View

Norrby S . Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 2008; 34(3):368-76. DOI: 10.1016/j.jcrs.2007.10.031. View

Shiraki N, Wakabayashi T, Sakaguchi H, Nishida K . Effect of Gas Tamponade on the Intraocular Lens Position and Refractive Error after Phacovitrectomy: A Swept-Source Anterior Segment OCT Analysis. Ophthalmology. 2019; 127(4):511-515. DOI: 10.1016/j.ophtha.2019.10.021. View

Soda M, Yaguchi S . Effect of decentration on the optical performance in multifocal intraocular lenses. Ophthalmologica. 2012; 227(4):197-204. DOI: 10.1159/000333820. View

Wang X, Chen X, Tang Y, Wang J, Chen Y, Sun X . Morphologic Features of Crystalline Lens in Patients with Primary Angle Closure Disease Observed by CASIA 2 Optical Coherence Tomography. Invest Ophthalmol Vis Sci. 2020; 61(5):40. PMC: 7405781. DOI: 10.1167/iovs.61.5.40. View

Zhu X, He W, Zhang Y, Chen M, Du Y, Lu Y . Inferior Decentration of Multifocal Intraocular Lenses in Myopic Eyes. Am J Ophthalmol. 2018; 188:1-8. DOI: 10.1016/j.ajo.2018.01.007. View

10.

Tsinopoulos I, Tsaousis K, Kymionis G, Symeonidis C, Grentzelos M, Diakonis V . Comparison of anterior capsule contraction between hydrophobic and hydrophilic intraocular lens models. Graefes Arch Clin Exp Ophthalmol. 2010; 248(8):1155-8. DOI: 10.1007/s00417-010-1373-2. View

11.

Lee D, Han J, Kim S, Byeon S, Koh H, Lee S . Long-term Effect of Scleral Encircling on Axial Elongation. Am J Ophthalmol. 2018; 189:139-145. DOI: 10.1016/j.ajo.2018.03.001. View

12.

Ozates S, Kiziltoprak H, Koc M, Uzel M, Teke M . INTRAOCULAR LENS POSITION IN COMBINED PHACOEMULSIFICATION AND VITREORETINAL SURGERY. Retina. 2017; 38(11):2207-2213. DOI: 10.1097/IAE.0000000000001840. View

13.

Weinberger D, Lichter H, Loya N, Axer-Siegel R, Muzmacher L, Gabbay U . Corneal topographic changes after retinal and vitreous surgery. Ophthalmology. 1999; 106(8):1521-4. DOI: 10.1016/S0161-6420(99)90447-5. View

14.

Tappin M, Larkin D . Factors leading to lens implant decentration and exchange. Eye (Lond). 2000; 14 Pt 5:773-6. DOI: 10.1038/eye.2000.202. View

15.

Iwama Y, Maeda N, Ikeda T, Nakashima H, Emi K . Impact of vitrectomy and air tamponade on aspheric intraocular lens tilt and decentration and ocular higher-order aberrations: phacovitrectomy versus cataract surgery. Jpn J Ophthalmol. 2020; 64(4):359-366. DOI: 10.1007/s10384-020-00737-0. View

16.

Korynta J, Bok J, Cendelin J . Changes in refraction induced by change in intraocular lens position. J Refract Corneal Surg. 1994; 10(5):556-64. View

17.

Kimura S, Morizane Y, Shiode Y, Hirano M, Doi S, Toshima S . Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography. PLoS One. 2017; 12(9):e0184066. PMC: 5581187. DOI: 10.1371/journal.pone.0184066. View

18.

Chen X, Gu X, Wang W, Xiao W, Jin G, Wang L . Characteristics and factors associated with intraocular lens tilt and decentration after cataract surgery. J Cataract Refract Surg. 2020; 46(8):1126-1131. DOI: 10.1097/j.jcrs.0000000000000219. View

19.

Cinar E, Yuce B, Aslan F, Erbakan G, Kucukerdonmez C . Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis. J Cataract Refract Surg. 2019; 45(11):1637-1644. DOI: 10.1016/j.jcrs.2019.07.017. View

20.

Holladay J, Piers P, Koranyi G, van der Mooren M, Norrby N . A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg. 2002; 18(6):683-91. DOI: 10.3928/1081-597X-20021101-04. View