BMC Ophthalmology (Oct 2024)

Assessment of intraocular lens tilt and decentration after femtosecond laser-assisted and conventional cataract surgery at 12 months and beyond

  • Bia Z. Kim,
  • Hayoung Lee,
  • Yoo Young Jeon,
  • Kyu Sang Eah,
  • Nahyun Park,
  • Ho Seok Chung,
  • Jae Yong Kim,
  • Hungwon Tchah,
  • Hun Lee

DOI
https://doi.org/10.1186/s12886-024-03720-2
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 8

Abstract

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Abstract Purpose To compare long-term intraocular lens (IOL) decentration and tilt following femtosecond laser-assisted cataract surgery (FLACS) and conventional surgery using swept-source anterior segment ocular coherence tomography (SS-ASOCT). Methods In this retrospective cross-sectional study, all patients underwent FLACS or conventional cataract surgery. Those with a minimum of 12-months follow-up since surgery were included. Patients with surgical complications were excluded. Demographics, preoperative ocular measurements (axial length, anterior chamber depth), and postoperative measurements [corrected distance visual acuity (CDVA), autorefraction, keratometry, IOL type] were collected. Postoperative IOL tilt and decentration were compared using SS-ASOCT between patients with FLACS and conventional cataract surgery. Subgroup analysis was conducted to analyze tilt and decentration by haptic type (single-piece vs. three-piece). Results A total of 188 eyes were included [110 (58.5%) in the FLACS group and 78 (41.5%) in the conventional group]. No differences were observed between the FLACS and conventional groups regarding preoperative parameters. FLACS resulted in less IOL decentration compared to conventional cataract surgery (170 μm vs. 240 μm, p = 0.002). No statistically significant differences were observed between the FLACS and conventional groups in the magnitude and axis of IOL tilt. Both groups had a trend of IOL tilt toward the inferotemporal aspects. Moreover, no difference regarding postoperative CDVA, spherical equivalent, and keratometric astigmatism was observed. Conclusions FLACS resulted in significantly better long-term IOL centration than conventional surgery with manual capsulotomy. No significant difference in IOL tilt or postoperative CDVA was observed between FLACS and conventional cataract surgery.

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