Abstract
Purpose: To evaluate which ocular axis, the corneal topographic axis (CTA), pupillary axis (PA) or line of sight (LOS), for measuring the tilt and decentration of intraocular lens (IOL) is most relevant to correct distance visual acuity (CDVA). Methods: A Scheimpflug device (Pentacam HR) was prospectively used to determine the tilt and decentration of IOLs in vivo 3 months after cataract surgery. A new method was developed to reliably measure PA and LOS. We further evaluated CTA and then used Spearman correlation coefficient and linear regression to assess the correlation between CDVA and IOL displacement based on the data of three different ocular axes. Results: Forty-six eyes from 46 patients were evaluated. The majority of decentration and tilt of IOL with reference to CTA, PA and LOS were towards the subtemporal direction. We found that the horizontal meridian data measured using CTA and PA were statistically significantly different (p = 0.011 for tilt; p = 0.005 for decentration). The correlation between CDVA and the distance of decentration temporally (r = –0.344, p = 0.035) and inferiorly (r = –0.336, p = 0.042) of the IOL with regard to CTA was significant. PA and LOS measurements had no correlation with any indices. Conclusion: Assessment of tilt and decentration of the IOL with reference to different ocular axes was markedly different. IOL tilt and decentration measured by CTA were significantly correlated with CDVA.
References
1.
Madrid-Costa
D
, Ruiz-Alcocer
J
, Pérez-Vives
C
, Ferrer-Blasco
T
, López-Gil
N
, Montés-Micó
R
. Visual simulation through different intraocular lenses using adaptive optics: effect of tilt and decentration
. J Cataract Refract Surg
. 2012
Jun
;38
(6
):947
–58
.
[PubMed]
0886-33502.
Chantarasorn
Y
, Techalertsuwan
S
, Siripanthong
P
, Tamerug
A
. Reinforced scleral fixation of foldable intraocular lens by double sutures: comparison with intrascleral intraocular lens fixation
. Jpn J Ophthalmol
. 2018
May
;62
(3
):365
–72
.
[PubMed]
0021-51553.
Ozates
S
, Kiziltoprak
H
, Koc
M
, Uzel
MM
, Teke
MY
. Intraocular lens position in combined phacoemulsification and vitroretinal surgery
. Retina
. 2017
.0275-004X4.
Maedel
S
, Hirnschall
N
, Bayer
N
, Markovic
S
, Tabernero
J
, Artal
P
, et al. Comparison of intraocular lens decentration and tilt measurements using 2 Purkinje meter systems
. J Cataract Refract Surg
. 2017
May
;43
(5
):648
–55
.
[PubMed]
0886-33505.
Rosales
P
, De Castro
A
, Jiménez-Alfaro
I
, Marcos
S
. Intraocular lens alignment from purkinje and Scheimpflug imaging
. Clin Exp Optom
. 2010
Nov
;93
(6
):400
–8
.
[PubMed]
0816-46226.
Kimura
S
, Morizane
Y
, Shiode
Y
, Hirano
M
, Doi
S
, Toshima
S
, et al. 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
Sep
;12
(9
):e0184066
.
[PubMed]
1932-62037.
Ding
X
, Wang
Q
, Chang
P
, Li
J
, Savini
G
, Huang
J
, et al. The Repeatability Assessment of Three-Dimensional Capsule-Intraocular Lens Complex Measurements by Means of High-Speed Swept-Source Optical Coherence Tomography
. PLoS One
. 2015
Nov
;10
(11
):e0142556
.
[PubMed]
1932-62038.
Ang
GS
, Duncan
L
, Atta
HR
. Ultrasound biomicroscopic study of the stability of intraocular lens implants after phacoemulsification cataract surgery
. Acta Ophthalmol
. 2012
Mar
;90
(2
):168
–72
.
[PubMed]
1755-375X9.
Chen
YA
, Hirnschall
N
, Maedel
S
, Findl
O
. Misalignment of a novel single-piece acrylic intraocular lens in the first three months after surgery
. Ophthalmic Res
. 2014
;51
(2
):104
–8
.
[PubMed]
0030-374710.
Eppig
T
, Scholz
K
, Löffler
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
Jun
;35
(6
):1091
–100
.
[PubMed]
0886-335011.
Chang
DH
, Waring
GO
4th. The subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices
. Am J Ophthalmol
. 2014
Nov
;158
(5
):863
–74
.
[PubMed]
0002-939412.
Park
CY
, Oh
SY
, Chuck
RS
. Measurement of angle kappa and centration in refractive surgery
. Curr Opin Ophthalmol
. 2012
Jul
;23
(4
):269
–75
.
[PubMed]
1040-873813.
Arbelaez
MC
, Alpins
N
, Verma
S
, Stamatelatos
G
, Arbelaez
JG
, Arba-Mosquera
S
. Clinical outcomes of laser in situ keratomileusis with an aberration-neutral profile centered on the corneal vertex comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism
. J Cataract Refract Surg
. 2017
Dec
;43
(12
):1504
–14
.
[PubMed]
0886-335014.
Holladay
JT
, Calogero
D
, Hilmantel
G
, Glasser
A
, MacRae
S
, Masket
S
, et al. Special Report: American Academy of Ophthalmology Task Force Summary Statement for Measurement of Tilt, Decentration, and Chord Length
. Ophthalmology
. 2017
Jan
;124
(1
):144
–6
.
[PubMed]
0161-642015.
Kanellopoulos
AJ
, Asimellis
G
, Georgiadou
S
. Digital pupillometry and centroid shift changes after cataract surgery
. J Cataract Refract Surg
. 2015
Feb
;41
(2
):408
–14
.
[PubMed]
0886-335016.
Walsh
G
. The effect of mydriasis on the pupillary centration of the human eye
. Ophthalmic Physiol Opt
. 1988
;8
(2
):178
–82
.
[PubMed]
0275-540817.
Tabernero
J
, Piers
P
, Benito
A
, Redondo
M
, Artal
P
. Predicting the optical performance of eyes implanted with IOLs to correct spherical aberration
. Invest Ophthalmol Vis Sci
. 2006
Oct
;47
(10
):4651
–8
.
[PubMed]
0146-040418.
Rosales
P
, Marcos
S
. Phakometry and lens tilt and decentration using a custom-developed Purkinje imaging apparatus: validation and measurements
. J Opt Soc Am A Opt Image Sci Vis
. 2006
Mar
;23
(3
):509
–20
.
[PubMed]
1084-752919.
Hu
CY
, Jian
JH
, Cheng
YP
, Hsu
HK
. Analysis of crystalline lens position
. J Cataract Refract Surg
. 2006
Apr
;32
(4
):599
–603
.
[PubMed]
0886-335020.
Arbelaez
MC
, Vidal
C
, Arba-Mosquera
S
. Clinical outcomes of corneal vertex versus central pupil references with aberration-free ablation strategies and LASIK
. Invest Ophthalmol Vis Sci
. 2008
Dec
;49
(12
):5287
–94
.
[PubMed]
0146-040421.
Holladay
JT
, Piers
PA
, Koranyi
G
, van der Mooren
M
, Norrby
NE
. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes
. J Refract Surg
. 2002
Nov-Dec
;18
(6
):683
–91
.
[PubMed]
1081-597X22.
Fernández
J
, Rodríguez-Vallejo
M
, Martínez
J
, Tauste
A
, Piñero
DP
. Biometric Factors Associated with the Visual Performance of a High Addition Multifocal Intraocular Lens
. Curr Eye Res
. 2018
Aug
;43
(8
):998
–1005
.
[PubMed]
0271-368323.
Pande
M
, Hillman
JS
. Optical zone centration in keratorefractive surgery. Entrance pupil center, visual axis, coaxially sighted corneal reflex, or geometric corneal center?
Ophthalmology
. 1993
Aug
;100
(8
):1230
–7
.
[PubMed]
0161-642024.
Ostern
AE
, Sandvik
GF
, Drolsum
L
. Positioning of the posterior intraocular lens in the longer term following cataract surgery in eyes with and without pseudoexfoliation syndrome
. Acta Ophthalmol
. 2014
May
;92
(3
):253
–8
.
[PubMed]
1755-375X25.
Arba Mosquera
S
, Verma
S
, McAlinden
C
. Centration axis in refractive surgery
. Eye Vis (Lond)
. 2015
Feb
;2
(1
):4
.
[PubMed]
2326-0254© 2019 S. Karger AG, Basel
2019
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
