Effect of manual capsulorhexis size and position on intraocular lens tilt, centration, and axial position.
Findl Oliver,Hirnschall Nino,Draschl Petra,Wiesinger Jörg
Journal of cataract and refractive surgery
PURPOSE:To evaluate the influence of a manual capsulorhexis size, shape, and position on postoperative axial position, tilt, and centration of intraocular lenses (IOLs). SETTING:Hanusch Hospital, Vienna, Austria. DESIGN:Prospective cases series. METHODS:Patients had cataract surgery and had follow-ups 1 hour and 3 months after surgery. Postoperatively, patients were divided into 3 groups according to the capsulorhexis shape and size as follows: control, symmetrical capsulorhexis between 4.5 mm and 5.5 mm; small group, capsulorhexis smaller than 4.5 mm; and eccentric, all other capsulorhexes. At both follow-ups, a retroillumination image, partial coherence interferometry measurements, and Purkinje meter measurements were performed. RESULTS:This study comprised 255 eyes. The mean postoperative absolute anterior chamber depth shift in the control, eccentric capsulorhexis, and small capsulorhexis groups was 0.31 mm ± 0.27 (SD), 0.36 ± 0.24 mm, and 0.26 ± 0.24 mm, respectively (P = .419). The mean tilt in the control, eccentric capsulorhexis, and small capsulorhexis groups was 4.08 ± 2.13 degrees, 3.66 ± 2.04 degrees, and 2.82 ± 1.67 degrees, respectively (P = .370), and the mean decentration was 0.38 ± 0.23 mm, 0.40 ± 0.21 mm, and 0.17 ± 0.08 mm, respectively (P = .027). CONCLUSIONS:Capsulorhexis size and shape had little effect on the capsular bag performance of modern IOLs. Only eyes with a severely malformed capsulorhexis had a slightly decentered IOL.
10.1016/j.jcrs.2017.04.037
Visual simulation through different intraocular lenses using adaptive optics: effect of tilt and decentration.
Madrid-Costa David,Ruiz-Alcocer Javier,Pérez-Vives Cari,Ferrer-Blasco Teresa,López-Gil Norberto,Montés-Micó Robert
Journal of cataract and refractive surgery
PURPOSE:To analyze visual quality differences between intraocular lenses (IOLs) and assess the impact of IOL decentration and tilt on visual quality. SETTING:University of Valencia, Valencia, Spain. DESIGN:Cohort study. METHODS:The crx1 adaptive optics visual simulator was used to simulate the wavefront aberration pattern of 2 commercially available aspheric aberration-correcting IOLs (Acrysof IQ SN60WF and Tecnis ZA9003) and 2 spherical IOLs (Akreos Adapt and Triplato) in 5 situations: centered, decentered 0.2 mm and 0.4 mm, and tilted 2 degrees and 4 degrees. Monocular distance visual acuity at 100%, 50%, and 10% contrast and the depth of focus were measured. RESULTS:Ten eyes of 10 patients were evaluated. When the IOLs were centered, there were no differences in visual acuity between the 4 IOLs at any contrast. The aberration-correcting IOLs were more sensitive to tilt and decentration than the spherical IOLs; Tecnis ZA9003 IOL was the most sensitive to decentration and the Acrysof IQ SN60WF IOL was the most sensitive to tilt. Higher residual spherical aberration slightly improved depth of focus and the tolerance to defocus. CONCLUSIONS:The results in this study suggest that the aspheric aberration-correcting and spherical IOLs provided comparable visual quality when centered in eyes in which the corneal higher-order aberrations are those of the average of the human cornea. Tilt and decentration of the IOLs had an impact on visual quality, with aberration-correcting IOLs having a greater effect than the spherical IOLs.
10.1016/j.jcrs.2012.01.029
Optical quality of aspheric toric intraocular lenses at different degrees of decentering.
Pérez-Vives Cari,Ferrer-Blasco Teresa,Madrid-Costa David,García-Lázaro Santiago,Montés-Micó Robert
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
PURPOSE:To analyze the optical quality of aspheric toric intraocular lenses (IOLs) at different degrees of decentering. METHODS:Wavefront aberrations of Acrysof IQ Toric IOLs (SN6AT3, SN6AT4, and SN6AT5; Alcon Laboratories Inc, Fort Worth, TX, USA) for different powers (15.00, 20.00 and 23.50 diopters [D]) and for different degrees of decentering (diagonal, horizontal, and vertical decentering of 0.3 and 0.6mm) were measured in vitro at 3- and 5-mm pupils. The Zernike coefficients of trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration were evaluated. The point spread functions (PSFs) and modulation transfer function (MTF) of each IOL evaluated were calculated from the wavefront aberrations. RESULTS:Coma aberration increased significantly with IOL decentration. Statistically significant differences were found between centered and all decentered positions in coma aberration (p < 0.05). Although, we only found visible differences between centered and decentered positions in PSF images and MTF curves for horizontal and vertical 0.6 mm of decentering at 3- and 5-mm pupil. CONCLUSIONS:Despite the coma increment, these values were clinically negligible and have no effect on visual performance, except for vertical and horizontal 0.6 mm of decentering, which could have a negative effect on visual quality.
10.1007/s00417-014-2629-z
Effects of decentration and tilt at different orientations on the optical performance of a rotationally asymmetric multifocal intraocular lens.
Liu Xiaomin,Xie Lixin,Huang Yusen
Journal of cataract and refractive surgery
PURPOSE:To assess the effects of decentration and tilt at different orientations on the optical quality of a rotationally asymmetric multifocal intraocular lens (IOL). SETTING:Shandong Eye Institute, Qingdao, China. DESIGN:Experimental study. METHODS:A rotationally asymmetric multifocal IOL (SBL-3) was tested using standardized optical bench testing. The optical quality was quantified using the modulation transfer function (MTF), through-focus MTF, and images of the United States Air Force Target test at apertures of 3.0 mm and 4.5 mm. The multifocal IOL was measured while it was centered, decentered by 0.3 mm and 0.5 mm, and then tilted by 3 degrees and 5 degrees at near-horizontal (near vision zone), distance-horizontal (distance vision zone), and vertical orientations of the long axis of the multifocal IOL. RESULTS:The optical performance was better at the aperture of 4.5 mm than at 3.0 mm for the centered multifocal IOL. The optical quality was improved at near focus and decreased at distance focus for the near-horizontal decentration, contrary to the status for the distance-horizontal decentration, with a more obvious tendency at the 3.0 mm aperture than at 4.5 mm. For the near-horizontal tilting, the optical quality at near focus was more significantly deteriorated than distance focus, opposite to that for the distance-horizontal tilting, with a more distinct tendency at a 4.5 mm aperture than at 3.0 mm. CONCLUSIONS:The optical quality of the asymmetric multifocal IOL was sensitive to and varied significantly after decentration and tilt at specific directions. The decentration induced increased or decreased optical quality, whereas tilt just yielded decreased optical quality.
10.1016/j.jcrs.2018.10.045