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Refractive error induced by intraocular lens tilt after intrascleral intraocular lens fixation

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Abstract

Purpose

To investigate the spherical shift of intraocular lens (IOL) tilt after intrascleral fixation.

Methods

We retrospectively reviewed the medical records of patients who underwent flanged intrascleral IOL fixation with transconjunctival 25- or 27-gauge pars plana vitrectomy at the Department of Ophthalmology of the Jikei University Hospital. The minimum follow-up duration was 3 months. Second-generation anterior segment optical coherence tomography (CASIA2; TOMEY) was used to obtain the values of tilt and decentration of the intrasclerally fixated IOL and postoperative anterior chamber depth. We investigated the relationship between refractive error and various parameters, such as IOL tilt and decentration, axial length, and keratometry. In addition to our clinical investigation, we conducted optical simulations using Zemax to evaluate the spherical shift of the IOL tilt by means of the through-focus response and change in spherical equivalent power.

Results

The study involved 72 eyes of 67 patients. The degree of IOL tilt was correlated with the amount of refractive error (Spearman’s rank correlation coefficient [CC] = − 0.32; P = 0.006). In particular, a tilt angle greater than 10° strongly affected the refractive error. The postoperative anterior chamber depth also correlated with the refractive error (CC = 0.50; P < 0.001), as opposed to decentration (CC = − 0.17; P = 0.15), axial length (CC = − 0.08; P = 0.49), and keratometry (CC = − 0.06; P = 0.64). Optical simulations also revealed a myopic shift that exponentially increased as the tilt became greater.

Conclusion

IOL tilts that are greater than 10° induce refractive error.

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Data availability

Clinical data supporting the findings of this study are available within the article and its Supplementary Information.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minatoku, Tokyo, 105-0003, Japan

    Teruaki Tokuhisa, Tomoyuki Watanabe, Akira Watanabe & Tadashi Nakano

Authors
  1. Teruaki Tokuhisa
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  2. Tomoyuki Watanabe
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  3. Akira Watanabe
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  4. Tadashi Nakano
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Contributions

The authors thank Tjundewo Lawu for conducting optical simulation using ZEMAX.

Corresponding author

Correspondence to Teruaki Tokuhisa.

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Conflict of interest

Financial interests: Author T. Nakano has received Grant from CREWT Medical Systems, Kyowa Medical, Kuribara Medical Instruments, Kowa, Tomey, Otsuka Pharmaceutical, Senju Pharmaceutical, MSD, Pfizer, Alcon Japan, Santen Pharmaceutical, NIDEK, AMO Japan Bayer, and IOL MEDICAL. Author T. Nakano has also received Personal Fees from Kowa, Otsuka Pharmaceutical, Senju Pharmaceutical, Santen Pharmaceutical, Nitto Medical, and Nikon.

Ethical approval

This study was conducted with approval from the institutional review board and in accordance with the ethical standards of the Helsinki Declaration of 1975, as revised in 2000 and 2008.The study protocol was approved by the Institutional Review Board of the Jikei University School of Medicine (approval no.:31–421[10003]), and all clinical procedures were conducted according to the principles of the Declaration of Helsinki.

Consent for participation

The study protocol was disclosed, and patients were given the opportunity to refuse participation in the study.

Consent to publishing

The study protocol was disclosed, and patients were given the opportunity to refuse participation in the study.

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Tokuhisa, T., Watanabe, T., Watanabe, A. et al. Refractive error induced by intraocular lens tilt after intrascleral intraocular lens fixation. Int Ophthalmol 42, 1213–1220 (2022). https://doi.org/10.1007/s10792-021-02106-3

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  • DOI: https://doi.org/10.1007/s10792-021-02106-3

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