Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography

Abstract

PurposeTo investigate the tilt and decentration of the crystalline lens and the intraocular lens (IOL) relative to the corneal topographic axis using anterior segment ocular coherence tomography (AS-OCT).MethodsA sample set of 100 eyes from 49 subjects (41 eyes with crystalline lenses and 59 eyes with IOLs) were imaged using second generation AS-OCT (CASIA2, TOMEY) in June and July 2016 at Okayama University. Both mydriatic and non-mydriatic images were obtained, and the tilt and decentration of the crystalline lens and the IOL were quantified. The effects of pupil dilation on measurements were also assessed.ResultsThe crystalline lens showed an average tilt of 5.15° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 5.25° under mydriatic conditions. Additionally, an average decentration of 0.11 mm towards the temporal direction was observed under non-mydriatic conditions and 0.08 mm under mydriatic conditions. The average tilt for the IOL was 4.31° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 4.65° in the same direction under mydriatic conditions. The average decentration was 0.05 mm towards the temporal direction under non-mydriatic conditions and 0.08 mm in the same direction under mydriatic conditions. A strong correlation was found between the average tilt and decentration values of the crystalline lens and the IOL under both non-mydriatic and mydriatic conditions (all Spearman correlation coefficients, r ≥ 0.800; all P < 0.001).ConclusionWhen measured using second generation AS-OCT, both the crystalline lens and the IOL showed an average tilt of 4–6° toward the inferotemporal direction relative to the corneal topographic axis and an average decentration of less than 0.12 mm towards the temporal direction. These results were not influenced by pupil dilation and they showed good repeatability.

Measurement of crystalline lens tilt in high myopic eyes before cataract surgery using swept-source optical coherence tomography

“…In this study, we used the IOLMaster 700 to measure ocular parameters, including the position of the crystalline lens. Other methods have previously been used to measure IOL tilt and decentration, such as ultrasound biomicroscopy [26], anterior-segment OCT [27], and Purkinje and Scheimpflug imaging [28][29][30]. In those studies, measurements were made with reference to different planes or axes, including the iris plane, the corneal topographic axis, the pupillary axis, and the visual axis.…”

Biometric Factors Associated with the Visual Performance of a High Addition Multifocal Intraocular Lens

“…Subjective ordinal scales are very useful in clinical practice when advanced systems are not available, such as the Lens Opacities Classification System III versus densitometry or ocular scatter index. 38 This is the first time that a subjective scale is proposed for measuring IOL centration with slit-lamp and the agreement with more precise technologies as OCT 39 or the inter-experimenter reproducibility of the grading should be assessed in future studies.…”

27-Gauge trocar-assisted sutureless intraocular lens fixation.

“…In this study, the mean postoperative IOL tilt was 3.52 ± 3.00° and decentration was 0.39 ± 0.39 mm. Kimura et al reported that the crystalline lens and the IOL showed an average tilt of 4-6˚ toward the inferotemporal direction relative to the corneal topographic axis and an average decentration of less than 0.12 mm [15]. Therefore, our technique resulted in greater IOL tilt and decentration than occurs in normal cataract surgery.…”