Evidence Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3639-3646
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3639
Tilt and decentration with various intraocular lenses: A narrative review
Xiao-Yong Chen, Yu-Chen Wang, Tian-Yao Zhao, Zi-Zhen Wang, Wei Wang
Xiao-Yong Chen, Yu-Chen Wang, Tian-Yao Zhao, Zi-Zhen Wang, Wei Wang, Department of Ophthalmology, Peking University The Third Hospital, Beijing 100191, China
Author contributions: Chen XY and Wang YC make substantial contributions to conception; Wang YC and Zhao TY review the literatures and draft the manuscript; Wang ZZ participates in the translation of articles; Wang W gives final approval of the version to be submitted and any revised version.
Supported by Haidian District Innovation and Transformation Fund of China, No. HDCXZHK2021212.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Wang, MD, PhD, Director, Doctor, Department of Ophthalmology, Peking University The Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Peking University Third hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. puh3_ww@bjmu.edu.cn
Received: August 9, 2021
Peer-review started: August 9, 2021
First decision: December 17, 2021
Revised: December 23, 2021
Accepted: March 7, 2022
Article in press: March 7, 2022
Published online: April 26, 2022
Processing time: 254 Days and 20.3 Hours
Abstract

We find that tilt and decentration of intraocular lens (IOL) commonly cause visual quality deterioration after cataract surgery. Multiple factors affect IOL tilt and decentration in the pre-, mid-, and post-operation phases. Moreover, the tilt and decentration of 1-piece IOL are less correlated with internal ocular HOAs than those of 3-piece IOL. Aspherical IOLs are more sensitive to decentration or tilt than spherical IOLs. Furthermore, the optical performance of toric IOLs with an accurate axis remains stable irrespective of tilt and decentration. The optical quality of asymmetric multifocal IOLs varies significantly after decentration and tilt in different directions. The image quality enhances or deteriorates in the direction of the decentered IOL. An extended depth of focus IOL can achieve good visual acuity in the distant, intermediate, and near range. Additionally, its tilt and decentration have less impact on the vision than bifocal and trifocal IOL. This is the first review that compares the effect of IOL tilt and decentration on image quality for various IOL designs. The result indicates that a deeper understanding of tilt and decentration of various IOLs can help achieve a better visual effect to visually improve refractive cataract surgery.

Keywords: Intraocular lens; Tilt and decentration; High order aberration; Visual quality

Core Tip: The tilt and decentration of intraocular lens (IOLs) definitely affect the effect of refractive cataract surgery, we review the contemporary literature on the IOL tilt and decentration. Furthermore, we explore the effects of IOL tilt and decentration on visual quality indicators, such as visual acuity, high-order aberration, point spread function, and modulation transfer function, for different IOL types. Moreover, we propose surgeon with refractive surgical skills performs the refractive cataract surgery with IOL.