J Korean Ophthalmol Soc.  2016 Apr;57(4):575-581. 10.3341/jkos.2016.57.4.575.

Effects of Continuous Curvilinear Capsulorhexis, Intraocular Lens Decentration and Tilt on Clinical Outcomes

• Eo DR
• Lim DH
• Hyun J
• Lee JY
• Lim HW
• Oh JE
• Chung ES
• Chung TY

• KMID: 2212790
• DOI: http://doi.org/10.3341/jkos.2016.57.4.575

Abstract

PURPOSE
To evaluate the effects of continuous curvilinear capsulorhexis, intraocular lens (IOL) decentration and tilt on postoperative clinical outcomes after cataract surgery.
METHODS
We reviewed 62 eyes of 52 patients who underwent cataract surgery and measured the uncorrected visual acuity, best corrected visual acuity and manifest refraction preoperatively and 3 months postoperatively. IOL decentration on anterior segment photography and IOL tilt on anterior optical coherent tomography were analyzed and correlations of postoperative uncorrected visual acuity, best corrected visual acuity, and higher order aberrations were evaluated. In addition, we inspected the relationship of size and decentration of continuous curvilinear capsulorhexis (CCC) intraoperatively with the change in IOL position postoperatively.
RESULTS
The average size of CCC was 5.40 ± 0.51 mm (4.12-6.24 mm) and the average decentration of CCC was 0.30 ± 0.19 mm (0.09-1.21 mm) intraoperatively. The average decentration of IOL was 0.23 ± 0.15 mm (0.00-0.71 mm) and the average IOL tilt was 1.43 ± 0.73° (0.00-4.22°) postoperatively. Intraoperative CCC size and decentration were associated with postoperative IOL decentration (p = 0.01, p < 0.001), but not with IOL tilt (p = 0.69, p = 0.52). There were no significant correlations between IOL decentration and tilt with postoperative visual outcomes and higher order aberrations.
CONCLUSIONS
The CCC size and decentration can affect the IOL decentration, but IOL decentration and tilt do not have a significant impact on clinical outcomes after cataract surgery.

Keyword

Continuous curvilinear capsulorhexis; Decentration; Higher-order aberrations; Intraocular lens; Tilt

MeSH Terms

Capsulorhexis*
Cataract
Humans
Lenses, Intraocular*
Photography
Visual Acuity

Figure

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  Figure 1. Anterior segment photography. Measurements of CCC size and decentration from the dilated pupil center in the intraoperative state (A) and IOL decantation in the postoperative state (B). CCC = continuous circular capsulorhexis; IOL = intraocular lens.

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  Figure 2. Measurement of IOL tilt angle in the x-axis (α‘) and y-axis (β‘) from the line connecting both scleral spurs using anterior segment OCT (Visante™ OCT). IOL = intraocular lens; OCT = optical coherence tomography.

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  Figure 3. Schematic images of calculation of intraocular lens tilt direction from visual axis. IOL = intraocular lens.

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  Figure 4. Plots of correlation of CCC with IOL. CCC size and IOL decentration (A), CCC size and IOL tilt (B), CCC decentration and IOL decentration (C), CCC decentration and IOL tilt (D). r² = coefficient of determination; CCC = continuous curvilinear capsulorhexis; IOL = intraocular lens.

Reference

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