title: Surgical approach affects intraocular lens decentration.
abstract: OBJECTIVE
  This study aims to quantify and identify risk factors for intraocular lens (IOL) tilt and decentration early after surgery using Scheimpflug imaging.
  
  
  METHODS
  We prospectively included 268 eyes of 253 patients who underwent uneventful cataract surgery and one-piece IOL implantation using a superior or temporal approach. Scheimpflug imaging was used to evaluate the tilt and decentration of IOLs at 1 week, 1 month, and 3 months postoperatively. Differences in IOL tilt and decentration between the approaches were examined. Correlations of age and axial length with the magnitudes of IOL decentration and tilt were also examined.
  
  
  RESULTS
  In total, 139 right and 129 left eyes were included. IOL displacement averaged 150 μm upward and 150 μm to the nasal side of the pupil. Over 50% of the eyes were tilted upward and approximately 90% to the temporal side. The surgical approach was significantly associated with horizontal decentration in both eyes, but significantly associated with only vertical decentration in the right eye 1 week postoperatively. In the left eyes, IOLs were shifted to the nasal side in 57.1% and 36.8% of the eyes that received the temporal and the superior approach, respectively, compared with 75.8% and 50% in the right eyes. The differences were significant only at 1-week follow-up (p = 0.035 and p = 0.003, respectively). Age or axial length was not associated with IOL tilt or decentration in either eye.
  
  
  CONCLUSIONS
  Scheimpflug imaging can be used as a quantitative tool to evaluate IOL position. The incision site affected the IOL position, this finding was significant at 1 week postoperatively only.
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, New Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Pei-Yao
authors.initials: PY
authors.lastname: Chang
authors.affiliation: Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan.
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Lian
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, New Taipei, Taiwan; Department of Medicine, National Yang Ming University, Taipei City, Taiwan.
authors.forename: Jia-Kang
authors.initials: JK
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, New Taipei, Taiwan.
authors.forename: Pei-Yuan
authors.initials: PY
authors.lastname: Su
authors.affiliation: Department of Healthcare Administration, Asia University, Wu-Feng, Taichung, Taiwan.
authors.forename: Jiun-Yi
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, New Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: swchang2007@ntu.edu.tw.
authors.forename: Shu-Wen
authors.initials: SW
authors.lastname: Chang
mesh_terms: D000368:Aged; D060437:Artificial Lens Implant Migration / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018918:Phacoemulsification / Q000379:methods*; D010781:Photography; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013624:Taiwan; D014792:Visual Acuity / Q000502:physiology
keywords: Scheimpflug imaging; intraocular lens decentration; intraocular lens position