Clinical Impact of Intraocular Lens Tilt and Decentration: A Cross-Sectional Study

Purpose To assess the impact of intraocular lens (IOL) tilt and decentration on visual performance within a clinical setting. Additionally, to explore the correlation between the capsulorhexis characteristics and IOL tilt and decentration. Methods This is a prospective study where patients who underwent uneventful cataract surgery and implanted with IOL Clareon CNA0T0 were evaluated with at least three months of follow-up. Best distance corrected visual acuity (BDCVA) and distance corrected intermediate visual acuity (DCIVA) were evaluated. Also, an anterior swept-source optical coherence tomography (OCT) was used to measure the IOL centration and tilt. The capsulorhexis characteristics were described by the area, perimeter, main semi-axes and roundness. Results A total of 246 eyes from 123 patients, 52 males and 71 females, were included in this study. The mean age was 73.75 ± 8.27 years old. The mean tilt was 5.31 ± 1.42 degrees and mean value of decentration was 0.27 ± 0.16 mm. Monocular BDCVA and DCIVA were 0 ± 0.05 and 0.37 ± 0.12 LogMAR respectively. The mean capsulorhexis area was 25.36 ± 6.42 mm ² and the mean roundness score was 0.93 ± 0.05. The correlation index between IOL tilt and BDCVA was 0.02 (p = 0.78). IOL tilt was not correlated with DCIVA (p = 0.1) Conclusions The IOL model studied presented low values in terms of tilt and decentration, comparable to others IOLs in the market. BCDVA and DCIVA are low correlated with those parameters and similarly, the shape and regularity of the capsulorhexis have no significant correlation with the tilt and decentration.