Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography

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Abstract

Purpose

To investigate the tilt and decentration of the crystalline lens and the intraocular lens (IOL) relative to the corneal topographic axis using anterior segment ocular coherence tomography (AS-OCT).

Methods

A sample set of 100 eyes from 49 subjects (41 eyes with crystalline lenses and 59 eyes with IOLs) were imaged using second generation AS-OCT (CASIA2, TOMEY) in June and July 2016 at Okayama University. Both mydriatic and non-mydriatic images were obtained, and the tilt and decentration of the crystalline lens and the IOL were quantified. The effects of pupil dilation on measurements were also assessed.

Results

The crystalline lens showed an average tilt of 5.15° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 5.25° under mydriatic conditions. Additionally, an average decentration of 0.11 mm towards the temporal direction was observed under non-mydriatic conditions and 0.08 mm under mydriatic conditions. The average tilt for the IOL was 4.31° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 4.65° in the same direction under mydriatic conditions. The average decentration was 0.05 mm towards the temporal direction under non-mydriatic conditions and 0.08 mm in the same direction under mydriatic conditions. A strong correlation was found between the average tilt and decentration values of the crystalline lens and the IOL under both non-mydriatic and mydriatic conditions (all Spearman correlation coefficients, r ≥ 0.800; all P < 0.001).

Conclusion

When measured using second generation AS-OCT, both the crystalline lens and the IOL showed an average tilt of 4–6° toward the inferotemporal direction relative to the corneal topographic axis and an average decentration of less than 0.12 mm towards the temporal direction. These results were not influenced by pupil dilation and they showed good repeatability.

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Most cited references 22

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A new intraocular lens design to reduce spherical aberration of pseudophakic eyes.

Jack Holladay, Patricia A Piers, Gabor Koranyi … (2015)

The aim of this study was to design and evaluate in the laboratory a new intraocular lens (IOL) intended to provide superior ocular optical quality by reducing spherical aberration. Corneal topography measurements were performed on 71 cataract patients using an Orbscan I. The measured corneal surface shapes were used to determine the wavefront aberration of each cornea. A model cornea was then designed to reproduce the measured average spherical aberration. This model cornea was used to design IOLs having a fixed amount of negative spherical aberration that partially compensates for the average positive spherical aberration of the cornea. Theoretical and physical eye models were used to assess the expected improvement in optical quality of an eye implanted with this lens. Measurements of optical quality provided evidence that if this modified prolate IOL was centered within 0.4 mm and tilted less than 7 degrees, it would exceed the optical performance of a conventional spherical IOL. This improvement occurred without an apparent loss in depth of focus. A new IOL with a prolate anterior surface, designed to partially compensate for the average spherical aberration of the cornea, is intended to improve the ocular optical quality of pseudophakic patients.

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Effect of decentration and tilt on the image quality of aspheric intraocular lens designs in a model eye.

Timo Eppig, Katja Scholz, Andre Löffler … (2009)

To determine the impact of decentration and tilt on the imaging quality of aspheric intraocular lens (IOL) designs in a schematic model eye. Institute of Medical Physics, University of Erlangen-Nuremberg, Erlangen, Germany. A model eye was used to calculate the impact of misalignment on the imaging quality of 6 IOL designs. The crystalline lens in the model eye was replaced with IOL designs with 22.0 diopters nominal refractive power, and the anterior chamber depth (ACD) was set to the estimated ACD value provided by the manufacturer. The retinal position was optimized for the best image quality. The IOLs were decentered up to +/-1.0 mm and tilted up to +/-5 degrees relative to the line of sight. At each position, the modulation transfer function was recorded with 3.0 mm and 4.5 mm pupil diameters. The results between the IOL designs and those of the phakic model eye were then compared. Aberration-correcting IOLs were very sensitive to decentration and tilt. However, the impact of misalignment depended on IOL design. Aberration-free IOLs showed less sensitivity within a wide range of displacement but provided better results than the spherical IOL. Overall, modern aspheric IOLs provided better imaging quality than conventional spherical IOL designs. Aberration-free IOLs were less sensitive to decentration and tilt than aberration-correcting IOLs but provided better image quality than spherical IOLs. Aberration-correcting IOLs have the potential to provide diffraction-limited imaging quality when perfectly aligned.

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Intraocular lens tilt and decentration, anterior chamber depth, and refractive error after trans-scleral suture fixation surgery.

Lilian Hayashi, Kentaro Hayashi, H. Hayashi … (1999)

To compare the extent of intraocular lens (IOL) tilt and decentration, as well as the anterior chamber depth after trans-scleral suture IOL fixation after either secondary out-of-the-bag or primary in-the-bag IOL implantation. Retrospective, comparative, nonrandomized, interventional study. Fifty-two eyes that underwent scleral suture fixation were compared with 51 eyes that underwent secondary out-of-the-bag implantation and 50 eyes that underwent in-the-bag implantation. One-piece polymethyl methacrylate IOL implantation by three different techniques. The tilt angle and decentration length of the IOL, as well as the anterior chamber depth, were measured by the Scheimpflug videophotography system. The spherical equivalent error from the predicted value was also examined. The mean tilt angle in the scleral suture fixation group was significantly greater than that in either the out-of-the-bag or the in-the-bag implantation group (P<0.0001). The mean decentration length was also largest in the suture group, followed by the out-of-the-bag group and the in-the-bag group (P<0.0001). The anterior chamber depth in the suture group and the out-of-the-bag group was significantly smaller than that in the in-the-bag group (P<0.0001). The spherical equivalent error in the suture group and the out-of-the-bag group was also greater than that in the in-the-bag group (P<0.0001). The extent of both tilt and decentration after scleral suture fixation was greater than that observed after either out-of-the-bag or in-the-bag implantation. The anterior chamber depth with the sutured or out-of-the-bag fixated IOL was shallower than that with the in-the-bag fixated IOL, which resulted in a significant myopic shift.

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Author and article information

Contributors

Shuhei Kimura:

ORCID: http://orcid.org/0000-0003-2565-277X

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing

Yuki Morizane: Role: SupervisionRole: Writing – original draftRole: Writing – review & editing

Yusuke Shiode: Role: Writing – original draftRole: Writing – review & editing

Masayuki Hirano: Role: Data curationRole: Formal analysis

Shinichiro Doi: Role: Data curationRole: Formal analysis

Shinji Toshima: Role: Data curationRole: Formal analysisRole: Project administration

Atsushi Fujiwara: Role: Software

Fumio Shiraga: Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – original draftRole: Writing – review & editing

Demetrios G. Vavvas: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 1 September 2017

Publication date Collection: 2017

Publication date (Corrected, electronic): 14 September 2017

Volume: 12

Issue: 9

Electronic Location Identifier: e0184066

Affiliations

[001]Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

Massachusetts Eye & Ear Infirmary, Harvard Medical School, UNITED STATES

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: shuheik@ 123456cc.okayama-u.ac.jp

Author information

Shuhei Kimura http://orcid.org/0000-0003-2565-277X

Article

Publisher ID: PONE-D-17-11751

DOI: 10.1371/journal.pone.0184066

PMC ID: 5581187

PubMed ID: 28863141

SO-VID: 1f26a370-1cd1-43e7-ba16-4580dc93559b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 26 March 2017

Date accepted : 17 August 2017

Page count

Figures: 5, Tables: 5, Pages: 12

Funding

The authors received no specific funding for this work.

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Data Availability All relevant data are within the paper and its Supporting Information files.

Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography

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Most cited references 22

A new intraocular lens design to reduce spherical aberration of pseudophakic eyes.

Effect of decentration and tilt on the image quality of aspheric intraocular lens designs in a model eye.

Intraocular lens tilt and decentration, anterior chamber depth, and refractive error after trans-scleral suture fixation surgery.

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