Risk Factors Associated With Intraocular Lens Decentration After Cataract Surgery

Am J Ophthalmol. 2022 May 18;242:88-95. doi: 10.1016/j.ajo.2022.05.005. Online ahead of print.


Purpose: To identify risk factors associated with intraocular lens (IOL) decentration after uneventful phacoemulsification with IOL implantation.

Design: A prospective cohort study.

Methods: All patients underwent a general ophthalmologic examination. One month postoperatively, the magnitude and orientation of IOL decentration relative to the visual axis center were assessed using an OPD-Scan III aberrometer, and the vertical and horizontal decentration values were determined. Univariate and multivariate linear regression analyses were performed to evaluate the association between the IOL decentration and ocular biometric parameters.

Results: In total, 143 eyes of 143 patients were enrolled. The mean decentration magnitude was 0.27 ± 0.15 mm, and the decentration axis appeared at any orientation, with no orientation tendency. The horizontal and vertical decentration were -0.02 ± 0.22 mm and 0.01 ± 0.22 mm, respectively. Multivariate regression analysis showed that the white-to-white distance and the magnitude of angle α were positively associated with the decentration magnitude (P < .001, adj. R2 = 0.121), the horizontal angle κ and horizontal angle α were positively associated with the horizontal decentration (P < .001, adj. R2 = 0.209), and the anterior chamber depth and vertical angle κ were positively associated with the vertical decentration (P < .001, adj. R2 = 0.152).

Conclusions: The IOL decentration magnitude was greater in patients with a larger white-to-white distance and a larger angle α, the horizontal decentration was greater in patients with a larger horizontal angle κ and a larger horizontal angle α, and the vertical decentration was greater in patients with a deeper anterior chamber depth and a larger vertical angle κ. In these patients, premium IOLs should be implanted cautiously.