title: Impact of intraocular lens haptic design and orientation on decentration and tilt.
abstract: OBJECTIVE
  To assess the effect of intraocular lens (IOL) orientation (vertical versus horizontal) and haptic design (1-piece versus 3-piece) on centration and tilt using a Purkinje meter.
  
  
  METHODS
  Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
  
  
  METHODS
  Randomized pilot study with intrapatient comparison.
  
  
  METHODS
  In part 1 of this study, patients received plate-haptic IOLs (Akreos Adapt) in both eyes that were positioned vertically in 1 eye and horizontally in the other eye. In part 2, patients received a 1-piece IOL (Acrysof SA60AT) in 1 eye and a 3-piece IOL (Acrysof MA60AC) in the contralateral eye. Decentration and tilt were measured 1 month and 3 months postoperatively with a new Purkinje meter.
  
  
  RESULTS
  In part 1 (n = 15), the mean decentration of plate-haptic IOLs was 0.4 mm ± 0.2 (SD) with vertical orientation and 0.4 ± 0.2 mm with horizontal orientation and the mean tilt, 1.5 ± 1.1 degrees and 2.9 ± 0.9 degrees, respectively. In part 2 (n = 15), the mean decentration was 0.4 ± 0.3 mm with 1-piece IOLs and 0.6 ± 0.8 mm with 3-piece IOLs and the mean tilt, 2.2 ± 7.2 degrees and 5.3 ± 2.4 degrees, respectively.
  
  
  CONCLUSIONS
  Three-piece IOLs had a greater tendency toward more decentration than 1-piece IOLs, perhaps because of slight deformation of 1 or both haptics during implantation or inaccuracies in production when the haptics are manually placed into the optic. The IOL orientation for plate-haptic IOLs appeared to have no effect on IOL position. The Purkinje meter was useful in assessing the capsule bag performance of the IOLs.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Alja
authors.initials: A
authors.lastname: Crnej
authors.forename: Nino
authors.initials: N
authors.lastname: Hirnschall
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Nishi
authors.forename: Vinod
authors.initials: V
authors.lastname: Gangwani
authors.forename: Juan
authors.initials: J
authors.lastname: Tabernero
authors.forename: Pablo
authors.initials: P
authors.lastname: Artal
authors.forename: Oliver
authors.initials: O
authors.lastname: Findl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration; D003941:Diagnostic Techniques, Ophthalmological; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D055095:Optics and Photonics; D018918:Phacoemulsification; D010865:Pilot Projects; D011474:Prosthesis Design; D011475:Prosthesis Failure