Original Article

Intraocular Lens Tilt and Decentration Measured By Scheimpflug Camera Following Manual or Femtosecond Laser–created Continuous Circular Capsulotomy

Kinga Kránitz, MD; Kata Miháltz, MD; Gábor L. Sándor, MD; Agnes Takacs, MD; Michael C. Knorz, MD; Zoltán Z. Nagy, MD, DSc

  • Journal of Refractive Surgery
  • April 2012 - Volume 28 · Issue 4: 259-263
  • DOI: 10.3928/1081597X-20120309-01
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Abstract

PURPOSE:

To compare intraocular lens (IOL) decentration and tilt following a circular capsulotomy created with a femtosecond laser (laser CCC) to a manually performed continuous curvilinear capsulorrhexis (manual CCC).

METHODS:

In a prospective, randomized study, a laser CCC (Alcon LenSx Inc) was performed in 20 eyes from 20 patients and a manual CCC was performed in 25 eyes from 25 patients. Intraocular lens decentration and tilt were measured using a Scheimpflug camera (Pentacam, Oculus Optikgeräte GmbH) 1 year after surgery. Uncorrected (UDVA) and corrected distance visual acuity (CDVA) and manifest refraction were also determined postoperatively. Between-group differences of IOL decentration and tilt as well as the correlation between IOL decentration and postoperative refractive changes and between IOL tilt and visual acuity were analyzed.

RESULTS:

Horizontal and vertical tilt were significantly higher in the manual CCC group (P=.007 and P<.001, respectively). Lenses implanted after manual CCC showed greater horizontal and total decentration (P=.034 and P=.022, respectively). Significant differences were found in the homogeneity of dichotomized IOL vertical tilt and both horizontal and total decentration distribution (P=.008, P=.036, and P=.017, respectively). Total IOL decentration showed a significant correlation with changes in manifest refraction values between 1 month and 1 year after surgery (R=0.33, P=.032). A significant correlation was noted between IOL vertical tilt and CDVA (R2=0.17, β=−0.41, 95% confidence limit: −0.69 to −0.13, P=.005).

CONCLUSIONS:

Continuous curvilinear capsulorrhexis created with a femtosecond laser resulted in a more stable refractive result and less IOL tilt and decentration than manual CCC.

AUTHORS

From Semmelweis University Budapest, Budapest, Hungary (Kránitz, Miháltz, Sándor, Takacs, Nagy); and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany (Knorz).

Drs Knorz and Nagy are consultants to Alcon LenSx Inc. The remaining authors have no financial interest in the materials presented herein.

Correspondence: Kinga Kránitz, MD, Semmelweis University Budapest, 1085 Budapest, Mária u. 39, Hungary. Tel: 36 20 825 8503; Fax: 36 1 317 9061; E-mail: kranitzkinga@gmail.com

Received: October 20, 2011
Accepted: February 24, 2012

doi: 10.3928/1081597X-20120309-01

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