Abstract
Purpose The purpose of this study was to quantify the characteristics of the tilt and decentration of the IOL after trans-scleral suture fixation surgery in congenital ectopia lentis (CEL) patients. Methods The clinical characteristics of 70 CEL patients at Zhongshan Ophthalmic Center in China were retrospectively analyzed. The tilt and decentration of intraocular lens (IOL) were measured by using a Pentacam and compared between different axial length (AL) subgroups. The correlation between IOL tilt, decentration, and ocular characteristics was investigated using Spearman's correlation analysis. Results The postoperative IOL position of CEL patients was mainly located nasally inferiorly. The average tilt of the IOL in CEL patients was less than 7° (for temporal: 2.21 ± 1.53°, for nasal: −1.84 ± 2.04°, for superior: 2.22 ± 2.18°, and for inferior: −1.70 ± 1.62°), and the average decentration of the IOL in CEL patients was larger than 0.4 mm (for temporal: 0.49 ± 0.38 mm, for nasal: −0.69 ± 0.46 mm, for superior: 0.72 ± 0.58 mm, and for inferior: −0.68 ± 0.54 mm). The decentration of CEL patients in the AL ≥ 26 subgroup was greater than those with AL < 24 mm and AL 24 to 26 mm subgroups (for superior: 0.72 ± 0.28 mm vs. 0.46 ± 0.25 mm and 0.48 ± 0.22 mm, all P < 0.05; for inferior: -0.94 ± 0.56 mm vs. −0.44 ± 0.26 mm and -0.44 ± 0.46 mm, all P < 0.05). IOL decentration was positively correlated with AL (for superior: r = 0.44, P=0.019; for inferior: r = 0.54, P=0.006). IOL tilt was positively correlated with AL on the superior side (r = 0.38, P=0.041). Conclusions The extent of IOL decentration after trans-scleral suture fixation was great in CEL patients, and the IOL decentration in CEL patients was significantly associated with AL.
Highlights
Congenital ectopia lentis (CEL) is a rare disease that is defined as the dislocation or displacement of the natural crystalline lens [1]
Pentacam has been commonly used in clinical practice to measure intraocular lens (IOL) tilt and decentration
By using Pentacam, we found that the postoperative IOL positions in CEL patients were mainly located nasally inferiorly, while the average tilt of IOLs in CEL patients was less than 7° in all four directions
Summary
Congenital ectopia lentis (CEL) is a rare disease that is defined as the dislocation or displacement of the natural crystalline lens [1]. Scleral suture-fixed posterior chamber intraocular lens (IOL) surgery is one of the most commonly performed surgical procedures for CEL patients. Most patients can achieve good visual outcomes with this surgical technology, more complications have been reported compared to the traditional surgery method, in which the IOL is implanted into the capsular bag, and the position of the IOL is one of the most important complications affecting visual quality [7, 8]. As previous studies have shown, IOL decentration greater than 0.4 mm and tilt greater than 7° could induce a lower visual performance [9]. Korynta found that an IOL tilt of 12° and decentration of 3 mm could result in a postoperative myopia of −7.0D and astigmatism of +4.0D [10]. The position of the IOL is important for a good visual prognosis
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