Intraocular lens tilt and decentration measured by Scheimpflug camera following manual or femtosecond laser-created continuous circular capsulotomy

J Refract Surg. 2012 Apr;28(4):259-63. doi: 10.3928/1081597X-20120309-01.


Purpose: To compare intraocular lens (IOL) decentration and tilt following a circular capsulotomy created with a femtosecond laser (laser CCC) to a manually performed continuous curvilinear capsulorrhexis (manual CCC).

Methods: In a prospective, randomized study, a laser CCC (Alcon LenSx Inc) was performed in 20 eyes from 20 patients and a manual CCC was performed in 25 eyes from 25 patients. Intraocular lens decentration and tilt were measured using a Scheimpflug camera (Pentacam, Oculus Optikgeräte GmbH) 1 year after surgery. Uncorrected (UDVA) and corrected distance visual acuity (CDVA) and manifest refraction were also determined postoperatively. Between-group differences of IOL decentration and tilt as well as the correlation between IOL decentration and postoperative refractive changes and between IOL tilt and visual acuity were analyzed.

Results: Horizontal and vertical tilt were significantly higher in the manual CCC group (P=.007 and P<.001, respectively). Lenses implanted after manual CCC showed greater horizontal and total decentration (P=.034 and P=.022, respectively). Significant differences were found in the homogeneity of dichotomized IOL vertical tilt and both horizontal and total decentration distribution (P=.008, P=.036, and P=.017, respectively). Total IOL decentration showed a significant correlation with changes in manifest refraction values between 1 month and 1 year after surgery (R=0.33, P=.032). A significant correlation was noted between IOL vertical tilt and CDVA (R(2)=0.17, β=-0.41, 95% confidence limit: -0.69 to -0.13, P=.005).

Conclusions: Continuous curvilinear capsulorrhexis created with a femtosecond laser resulted in a more stable refractive result and less IOL tilt and decentration than manual CCC.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anterior Capsule of the Lens / surgery*
  • Artificial Lens Implant Migration / diagnosis*
  • Artificial Lens Implant Migration / etiology
  • Artificial Lens Implant Migration / prevention & control
  • Capsulorhexis / methods*
  • Female
  • Humans
  • Laser Therapy*
  • Lasers, Excimer
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Photography / methods*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Visual Acuity / physiology