Tilt and Decentration of Three-Piece Foldable High-Refractive Silicone and Hydrophobic Acrylic Intraocular Lenses With 6-mm Optics in an Intraindividual Comparison
“…Tilt and decentration of the posterior IOLs are comparable to those with standard implantation of only 1 foldable IOL in the capsular bag. 27 In contrast, the anterior IOLs placed in the ciliary sulcus showed higher degrees of tilt and decentration, but no instability. One must take into consideration that the anterior IOLs were originally designed for the capsular bag and their 12.5 or 13.00 mm total diameter might be too small for sulcus implantation.…”
Piggyback IOL implantation with placement of 2 foldable IOLs in the capsular bag can be followed by a hyperopic shift that may be caused in part by displacement of the IOLs. Placement of the anterior IOL in the ciliary sulcus can lead to higher decentration of this IOL.
“…Tilt and decentration of the posterior IOLs are comparable to those with standard implantation of only 1 foldable IOL in the capsular bag. 27 In contrast, the anterior IOLs placed in the ciliary sulcus showed higher degrees of tilt and decentration, but no instability. One must take into consideration that the anterior IOLs were originally designed for the capsular bag and their 12.5 or 13.00 mm total diameter might be too small for sulcus implantation.…”
Piggyback IOL implantation with placement of 2 foldable IOLs in the capsular bag can be followed by a hyperopic shift that may be caused in part by displacement of the IOLs. Placement of the anterior IOL in the ciliary sulcus can lead to higher decentration of this IOL.
“…These decentration and tilt values were used because the mean IOL decentration reported in the literature ranges between 0.2 mm and 0.4 mm and the mean tilt, between 2 degrees and 4 degrees. [22][23][24][25][26] The MTF for the refractive-diffractive IOL was slightly affected by tilt; note that the cutoff frequency is stable at approximately 50 cpd, which corresponds to a Snellen decimal visual acuity of approximately 1.5 (20/13, visual resolution in white light). When the IOL was decentered (0.2 to 0.4 mm), the cutoff frequency was reduced to Radial projection averaged over all orientations of the 2-dimensional MTF for 780 nm and a 5 mm pupil versus spatial frequency (cpd) (distance focus) (diffraction-limited curve included for comparison).…”
The refractive-diffractive IOL provided better optical quality than the nonrotational symmetric IOL. Tilt and decentration had a significant impact on optical quality with both IOLs, being more severe with the nonrotational symmetric IOL.
“…The clinical literature includes numerous reports of IOL tilt and decentration at different times after surgery or with different IOL types using commercial Scheimpflug instruments. [22][23][24][25][26][27][28] With these instruments, the optical distortion is presumably not corrected. Only a recent study of IOL tilt and decentration in eyes with phakic lenses 29 using a Nidek Scheimpflug system mentions that images were corrected using custom algorithms.…”
Both systems showed high reproducibility. Validation experiments on physical model eyes showed slightly higher accuracy with the Purkinje method than the Scheimpflug imaging method. Horizontal measurements of patients with both techniques were highly correlated. The IOLs tended to be tilted and decentered nasally in most patients.
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