Decentration and tilt of plate-haptic multifocal intraocular lenses in myopic eyes

Abstract

Background: To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses (MfIOLs) in myopic eyes. Methods: Myopic (axial length [AXL] > 24.5 mm) and non-myopic (21.0 mm < AXL ≤ 24.5 mm) cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses (Group A) or Tecnis ZMB00 lenses (Group B). In total, 122 eyes of 122 patients were available for analysis. Decentration and tilt of MfIOLs, high-order aberrations (HOAs), and modulation transfer functions (MTFs) were evaluated using the OPD-Scan III aberrometer 3 months postoperatively. Subjective symptoms were assessed with a Quality of Vision questionnaire. Results: Near and distance visual acuities, tilt and horizontal decentration did not differ between the two groups, postoperatively. However, myopic eyes of Group B showed greater vertical decentration than those of Group A (− 0.17 ± 0.14 mm vs.-0.03 ± 0.09 mm, respectively), particularly when the MfIOLs were placed horizontally or obliquely. Overall decentration of myopic eyes was greater in Group B than in Group A (0.41 ± 0.15 mm vs. 0.16 ± 0.10 mm, respectively). In Group B, AXL was negatively correlated with vertical decentration and positively correlated with overall decentration. No such correlations were found in Group A. Intraocular total HOAs, coma, trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes. Generally, Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes. Conclusions: Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.

Comparison of Clinical Outcomes, Visual Quality and Visual Function of Two Presbyopia-Correcting Intraocular Lenses Made from the Same Material, but with Different Design and Optics

“…Because AXL was similar in the two IOL groups in our study (p = 0.6400), we believe that the differences between groups in the refractive and visual outcomes are not attributable to this anatomical parameter. IOL decentration and tilt were not measured in our study, although both the Liberty and AT LISA tri IOLs have been reported to undergo some decentration following implantation [24,39]. IOL decentration can affect refractive and visual outcomes [38,40].…”

“…The explanation for the better refractive predictability of the Liberty IOL is also unclear. Comparing two MFIOLs, Meng et al reported that a plate haptic lens had better positional stability in the capsular bag than a lens with a C-loop haptic in myopic eyes (AXL > 24.5 mm) and noted no differences in non-myopic eyes (21.0 mm < AXL ≤ 24.5 mm) [39]. Because AXL was similar in the two IOL groups in our study (p = 0.6400), we believe that the differences between groups in the refractive and visual outcomes are not attributable to this anatomical parameter.…”

Rotational Stability, Tilt and Decentration of a New IOL with a 7.0 mm Optic

“…4,7 Underlying reasons for this early rotation might be remaining OVD behind the IOL, myopia and concomitant greater capsular bag size 18 but also insufficient IOL-capsulorhexis overlap (<0.5 mm). 5,6,19 In our study, the use of different OVDs for filling the capsular bag did not have an impact on the rotation stability. Overall, only in one IOL, rotation exceeded 10.0 degrees within one day of surgery (EoS vs. 1 day).…”

“…This is in agreement with the recent findings of Meng et al who compared C-loop haptics and plate-haptics within myopes and non-myopes in terms of tilt and decentration. 6 While platehaptics were more stable in myopic eyes, there was no increase of tilt and decentration with greater axial length within this group.…”

“…Nonetheless, all IOLs are not equal and their post-operative behavior in the capsular bag is highly dependent on their unique design. Several factors have been reported to contribute to IOL stability including IOL material properties, 3 IOL overall diameter, 4 haptics design combined with axial length (AL), 5,6 IOL surface treatment 3 and haptic texture. 7 Therefore, measurement of the postoperative stability of a new lens design is essential to ensure that the IOL platform is adequate for the development of premium IOLs.…”