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Review

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

1
Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton BN2 5BF, UK
2
Eastbourne District General Hospital, Kings Drive, Eastbourne BN21 2UD, UK
3
Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK
4
Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK
*
Author to whom correspondence should be addressed.
Vision 2020, 4(3), 41; https://doi.org/10.3390/vision4030041
Received: 29 June 2020 / Revised: 17 August 2020 / Accepted: 11 September 2020 / Published: 14 September 2020
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. View Full-Text
Keywords: intraocular lens; tilt; decentration; wavefront aberration; visual acuity; dysphotopsia intraocular lens; tilt; decentration; wavefront aberration; visual acuity; dysphotopsia
MDPI and ACS Style

Ashena, Z.; Maqsood, S.; Ahmed, S.N.; Nanavaty, M.A. Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations. Vision 2020, 4, 41. https://doi.org/10.3390/vision4030041

AMA Style

Ashena Z, Maqsood S, Ahmed SN, Nanavaty MA. Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations. Vision. 2020; 4(3):41. https://doi.org/10.3390/vision4030041

Chicago/Turabian Style

Ashena, Zahra, Sundas Maqsood, Syed Naqib Ahmed, and Mayank A. Nanavaty. 2020. "Effect of Intraocular Lens Tilt and Decentration on Visual Acuity, Dysphotopsia and Wavefront Aberrations" Vision 4, no. 3: 41. https://doi.org/10.3390/vision4030041

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