Tilt and decentration of an intraocular lens implanted in the ciliary sulcus after capsular bag defect during cataract surgery

To determine the impact of ciliary sulcus implantation after capsular bag defect on tilt and decentration of foldable intraocular lenses (IOL) measured by a novel device. This prospective noncomparative single-center investigation included patients (N = 10) older than age 60 who underwent cataract surgery with a posterior capsular bag defect and implantation of a threepiece hydrophilic aberration neutral IOL (OphthalmoPro AC 7013) in the ciliary sulcus. All eyes (N = 10) were examined using the OPD-Scan II (Nidek). Spherical aberration (Z4,0), vertical coma (Z3,-1), and horizontal coma (Z3,1) were calculated for a 5.0 mm pupil. Lens tilt and decentration was studied using a new Purkinjemeter. The mean horizontal optic tilt was 7.68A degrees A +/- 5.16 (SD) and the mean vertical optic tilt was 3.01A degrees A +/- 2.44 (SD). Horizontal decentration was 0.4 A +/- 0.33 mm (SD) and vertical decentration was 0.31 A +/- 0.21 mm (SD). Corneal aberrations were partially compensated by IOL- related aberrations. Both tilt and decentration of sulcus-fixated IOLs exceeded the tolerable amounts evaluated for aspheric IOLs in eye model experiments. However, these spheric IOLs showed mitigation rather than accentuation of corneal wavefront aberrations in the rare event of capsular bag defect during cataract surgery.