The effect of intraocular lens tilt on visual outcomes in scleral-fixated intraocular lens implantation

Atik, Burcu Kemer; Altan, Çiğdem; Ağca, Alper; Kirmaci, Asli; Yıldırım, Yusuf; Genç, Selim; Taşkapili, Mühittin

doi:10.1007/s10792-019-01233-2

Cited by 25 publications

(17 citation statements)

References 17 publications

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“…The line connecting the irido-corneal scleral spurs has been the reference line to assess the IOL tilt in the majority of these studies. Kemer et al [ 38 ] reported the mean IOL tilt angle of 3.80° ± 4.09° in the horizontal axis and 2.83° ± 4.03° in the vertical axis in 94 eyes with Z-sutured scleral fixated using AS-OCT without pupil dilation. Barca et al [ 39 ] reported mean tilt of 2.08° ± 1.19° in 32 eyes with a sutureless single piece scleral fixated IOL following pupil dilation and Ibrahim et al [ 40 ] reported lens decentration range between 0.21 mm and 0.9 mm and IOL tilt ranged between 1.2° and 2.8° in 6 patients with suture fixated sulcus IOLs using AS-OCT. CASIA2 (Tomey Corp., Nagoya, Japan) is a second-generation Swept source AS-OCT with scan depth of 13 mm [ 5 ].…”

Section: Measurement Of Iol Tilt and Decentrationmentioning

confidence: 99%

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Ashena

Maqsood

Ahmed

et al. 2020

Vision

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Tilt and decentration of intraocular lenses (IOL) may occur secondary to a complicated cataract surgery or following an uneventful phacoemulsification. Although up to 2–3° tilt and a 0.2–0.3 mm decentration are common and clinically unnoticed for any design of IOL, larger extent of tilt and decentration has a negative impact on the optical performance and subsequently, the patients’ satisfaction. This negative impact does not affect various types of IOLs equally. In this paper we review the methods of measuring IOL tilt and decentration and focus on the effect of IOL tilt and decentration on visual function, in particular visual acuity, dysphotopsia, and wavefront aberrations. Our review found that the methods to measure the IOL displacement have significantly evolved and the available studies have employed different methods in their measurement, while comparability of these methods is questionable. There has been no universal reference point and axis to measure the IOL displacement between different studies. A remarkably high variety and brands of IOLs are used in various studies and occasionally, opposite results are noticed when two different brands of a same design were compared against another IOL design in two studies. We conclude that <5° of inferotemporal tilt is common in both crystalline lenses and IOLs with a correlation between pre- and postoperative lens tilt. IOL tilt has been noticed more frequently with scleral fixated compared with in-the-bag IOLs. IOL decentration has a greater impact than tilt on reduction of visual acuity. There was no correlation between IOL tilt and decentration and dysphotopsia. The advantages of aspheric IOLs are lost when decentration is >0.5 mm. The effect of IOL displacement on visual function is more pronounced in aberration correcting IOLs compared to spherical and standard non-aberration correcting aspherical IOLs and in multifocal versus monofocal IOLs. Internal coma has been frequently associated with IOL tilt and decentration, and this increases with pupil size. There is no correlation between spherical aberration and IOL tilt or decentration. Although IOL tilt produces significant impact on visual outcome in toric IOLs, these lenses are more sensitive to rotation compared to tilt.

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Section: Measurement Of Iol Tilt and Decentrationmentioning

confidence: 99%

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Ashena

Maqsood

Ahmed

et al. 2020

Vision

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“…Although visually significant decentration and tilt were not identified on visual inspection of OCT images, both factors will affect the imaging properties of the IOL and increase the error between measured and predicted refraction, albeit not to the extent of clinical significance. 32 Paraxial optics predicts the optical performance of optical system in a central zone close to the optical axis where the effect of aberrations is negligible. It has been suggested that the reduced predictability of IOL power calculation after refractive surgery is caused by the presence of increased corneal aberrations after refractive surgery.…”

Section: Discussionmentioning

confidence: 99%

Predictability of pseudophakic refraction using patient-customized paraxial eye models

Chang

Cabot

Heilman

et al. 2022

J Cataract Refract Surg

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“…Placing the haptics in their “physiological” position with 2 threads of 10-0 polypropylene guarantees a central position of the IOL with no tilting or instability. However, those results might not be reproduced if the suture is performed on haptics with an eyelet or with only one suture per haptic [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

The SWISS IOL Technique (Small-Width Incision Scleral Suture): A Mini-Invasive Technique

Kecik

Pajic

Quoy

et al. 2021

Journal of Ophthalmology

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Purpose. To evaluate the outcomes and safety of a minimally invasive technique for sutured IOL scleral fixation in case of compromised capsular and iris support. Materials and Methods. In this retrospective study, we explain our mini-invasive technique and assess the outcomes in terms of visual acuity, pre- or postoperative complications, and IOL position (Sensar AR40e, AMO) in a case series of three patients. Results. The expected best corrected visual acuity could be achieved after one month. Surgeries were uneventful with a stable eye. No postoperative complications occurred except for one patient who had a conjunctival disinsertion. Neither postoperative hypotony nor raised IOP was found. Additionally, no patient experienced corneal edema at one week control, IOL dislocation, vitreous hemorrhage, or new pupil’s irregularity. Conclusions. In conclusion, each scleral technique has its own advantages and its inherent postoperative complications. To date, there is no evidence of superiority of any single technique. By improving our scleral sutured lens techniques, we could improve peroperative ocular stability, potentially decrease postoperative complication rate, and offer a rapid recovery with a stable visual acuity within a month.

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The effect of intraocular lens tilt on visual outcomes in scleral-fixated intraocular lens implantation

Cited by 25 publications

References 17 publications

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations

Predictability of pseudophakic refraction using patient-customized paraxial eye models

The SWISS IOL Technique (Small-Width Incision Scleral Suture): A Mini-Invasive Technique

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