Original article
Inferior Decentration of Multifocal Intraocular Lenses in Myopic Eyes

https://doi.org/10.1016/j.ajo.2018.01.007Get rights and content

Purpose

To investigate the tilt and decentration of multifocal intraocular lenses (MfIOLs) implanted in myopic eyes.

Methods

Twenty-eight myopic eyes and 56 emmetropic eyes were evaluated. Phacoemulsification with Tecnis ZMB00 MfIOL (Abbott Medical Optics, Santa Ana, California, USA) implantation was performed. At 1 year post-surgery, routine postoperative examinations were performed, and tilt and decentration of the MfIOLs, high-order aberrations, and modulation transfer function (MTF) were evaluated using the OPD-Scan III aberrometer (Nidek Co, Ltd, Gamagori, Japan). Subjective symptoms were assessed with a Quality of Vision questionnaire.

Results

Postoperative uncorrected distance visual acuity (VA), best-corrected distance VA, and uncorrected near VA did not differ between the 2 groups. The mean IOL tilt and horizontal decentration were not different between the control and myopic groups. However, the myopic group presented significantly inferior decentration in the capsular bag compared with the control group (−0.03 ± 0.22 mm vs −0.21 ± 0.29 mm, P = .002). The overall decentration values were 0.32 ± 0.14 mm in the controls and 0.40 ± 0.18 mm in the myopic group (P = .023). Axial length was negatively correlated with vertical decentration (r = −0.268, P = 0.014) and positively correlated with overall decentration (r = 0.334, P = .002). Worse aberration data, poorer MTF, and more subjective symptoms were also found in the myopic group than in the controls.

Conclusion

Greater inferior decentration of MfIOLs and a consequent decrease in visual quality were found in myopic eyes, indicating that the increasing incompatibility between IOL and capsular bag size with axial length elongation should not be underestimated.

Section snippets

Methods

This prospective cohort study was approved by the Institutional Review Board of the Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China. All procedures adhered to the tenets of the Declaration of Helsinki. All patients provided written informed consent for their medical records to be used for research purposes. The study was registered at www.clinicaltrials.gov (accession number NCT03062085).

Results

Table 1 provides the patients' demographic data. No statistically significant between-group differences were identified for age, sex, operated eye, or preoperative visual acuity (Student t tests for age and preoperative visual acuity, χ2 tests for sex and operated eye, all P > .05). Postoperative uncorrected distance, best-corrected distance, and uncorrected near visual acuities did not differ significantly between the 2 groups (Student t tests, all P > .05). AXL was significantly longer in the

Discussion

Despite the wide application of MfIOLs, there is still uncertainty regarding their use in myopic eyes.12, 16 Many surgeons are concerned that complicated fundal conditions in myopic eyes impair MfIOL optical function.17, 18 However, few have considered IOL instability induced by incompatibility between fixed and increased sizes of IOLs and capsular bags in myopic eyes, respectively. In the current study, we used an OPD-Scan III aberrometer to evaluate the tilt and decentration of MfIOLs

References (38)

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