Clinical Observation Of Decentration And Tilt After In-the-bag Implantation Of Five Aspheric Intraocular Lenses

Objective: To investigate the decentration and tilt of patients with age-related cataract after in-the-bag implantation of five different aspheric intraocular lenses(IOLs).To explore the factors affecting the in-the-bag stabilities of intraocular lenses.Methods: Prospective clinical trial.A total of 143 patients(155 eyes)with age-related cataract were enrolled between October 2017 and March 2018 from the Fourth Affiliated Hospital of China Medical University.All patients undergoing phacoemulsification received CT Asphina 509 M IOL(Zeiss,Germany),Tecnis ZCB00 IOL(AMO,USA),Acrysof IQ SA60 AT IOL(Alcon,USA),AF1-251 IOL(HOYA,Japan)or CT LUCIA601 P IOL(Zeiss,Germany)based on the voluntary principle.Before cataract surgery,we use iTrace(Tracey Technologies,USA)measure angle kappa(the difference between the pupillary and visual axis)and alpha(the difference between the optic and visual axis).Follow-up visits were conducted at 1 week,1 month and 3 months postoperatively.Visual acuity,angle kappa and alpha were examined.IOL decentration and tilt were measured using the Pentacam(Oculus Optikger?te GmbH,Germany).Results:At 1 week and 1 month after operation,the difference in decentration among the five IOLs was statistically significant(P<0.05),while the difference in tilt and best-corrected visual acuity(BCVA)after surgery was not statistically significant(P<0.05).At 1 week and 1 month after operation,decentration in the 509 M,Tecnis and HOYA 251 groups were significantly lower than that in the LUCIA group,and decentration in the 509 M group was lower than that in the IQ group at 1 week after operation(P<0.05).At 3 months after operation,the decentration,tilt and BCVA of the five different IOLs were compared,the differences were not statistically significant(P>0.05).Preoperative angle kappa was positively correlated with IOL tilt at 1 week,1month,and 3 months after surgery(r=0.277,P=0.002;r=0.368,P<0.001;r=0.258,P=0.011),preoperative angle alpha was positively correlated with IOL tilt at 1 week,1month,and 3 months after surgery(r=0.319,P<0.001;r=0.43,P<0.001;r=0.369,P<0.001).During the same follow-up period,postoperative angle kappa was positively correlated with IOL decentration and tilt(r=0.167,P<0.001;r=0.288,P<0.001),and postoperative angle alpha was positively correlated with IOL decentration and tilt(r=0.115,P=0.014;r=0.441,P<0.001).Angle kappa was positively correlated with angle alpha(r=0.359,P<0.001).Conclusion: Five different types of aspheric IOLs perform equally well in terms of the in-the-bag stabilities.To some extent,preoperative angle kappa and alpha can be used as indicators to predict postoperative IOL tilt.