Chen Xiao-Yong, Wang Yu-Chen, Zhao Tian-Yao, Wang Zi-Zhen, Wang Wei
Department of Ophthalmology, Peking University The Third Hospital, Beijing 100191, China.
World J Clin Cases. 2022 Apr 26;10(12):3639-3646. doi: 10.12998/wjcc.v10.i12.3639.
We find that tilt and decentration of intraocular lens (IOL) commonly cause visual quality deterioration after cataract surgery. Multiple factors affect IOL tilt and decentration in the pre-, mid-, and post-operation phases. Moreover, the tilt and decentration of 1-piece IOL are less correlated with internal ocular HOAs than those of 3-piece IOL. Aspherical IOLs are more sensitive to decentration or tilt than spherical IOLs. Furthermore, the optical performance of toric IOLs with an accurate axis remains stable irrespective of tilt and decentration. The optical quality of asymmetric multifocal IOLs varies significantly after decentration and tilt in different directions. The image quality enhances or deteriorates in the direction of the decentered IOL. An extended depth of focus IOL can achieve good visual acuity in the distant, intermediate, and near range. Additionally, its tilt and decentration have less impact on the vision than bifocal and trifocal IOL. This is the first review that compares the effect of IOL tilt and decentration on image quality for various IOL designs. The result indicates that a deeper understanding of tilt and decentration of various IOLs can help achieve a better visual effect to visually improve refractive cataract surgery.
我们发现，人工晶状体（IOL）的倾斜和偏心通常会导致白内障手术后视觉质量下降。多种因素在手术前、手术中和手术后阶段影响IOL的倾斜和偏心。此外，单片式IOL的倾斜和偏心与眼内高阶像差（HOAs）的相关性低于三片式IOL。非球面IOL比球面IOL对偏心或倾斜更敏感。此外，轴位准确的散光IOL的光学性能无论倾斜和偏心如何都保持稳定。不对称多焦点IOL在不同方向偏心和倾斜后的光学质量有显著差异。在偏心IOL的方向上，图像质量会提高或下降。扩展景深IOL在远、中、近视力范围内都能实现良好的视力。此外，其倾斜和偏心对视力的影响比双焦点和三焦点IOL小。这是第一篇比较IOL倾斜和偏心对各种IOL设计图像质量影响的综述。结果表明，更深入地了解各种IOL的倾斜和偏心有助于实现更好的视觉效果，从而在视觉上改善屈光性白内障手术。
