Ocular higher-order wavefront aberration caused by major tilting of intraocular lens.

PURPOSE

To report a patient with a significant amount of ocular coma-like aberration that was caused by the tilting of an intraocular lens (IOL) who was treated successfully by IOL repositioning surgical procedure.

DESIGN

Interventional case report.

METHODS

At the Department of Ophthalmology, University of Tsukuba, a 52-year-old man complained of unclear and distorted vision in his left pseudophakic eye. The tilt and decentration of IOL were measured with the Scheimpflug videophotography system. Ocular and corneal wavefront aberrations were measured with the Hartmann-Schack aberrometer.

RESULTS

The tilting angle was 28.87 degrees, and decentration was 1.78 mm. The ocular coma-like aberration was increased remarkably to 0.451 microm at 4.0 mm aperture diameter, and the simulated retinal image of a Landolt ring was blurred substantially. Ocular spheric-like, corneal coma-like, and corneal spheric-like aberrations were not increased. The IOL repositioning surgery significantly improved the IOL tilt, which resulted in the reduction of ocular coma-like aberration, recovery of simulated retinal image, and resolution of the patient's complaints.

CONCLUSION

Major IOL tilting induces a large amount of ocular coma-like aberration, which deteriorates the patient's quality of vision.