Postoperative intraocular lens stability following cataract surgery with or without primary posterior continuous curvilinear capsulorrhexis: an intra-individual randomized controlled trial

International Ophthalmology - Tập 43 - Trang 4759-4771 - 2023
Yue Huang1, Mengting Yu2, Xiaobao Liu1, Qiong Li1,3, Xiaozheng Ke3, Yajing Cai1, Wenjie Wu1,3
1Ophthalmology Department, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
3Ophthalmology Department, Fujian Provincial Hospital, Fuzhou, China

Tóm tắt

To evaluate the effect of primary posterior continuous curvilinear capsulorrhexis (PPCCC) on the positional stability of IOLs. This study is a prospective intra-individual comparative randomized controlled trial including 31 patients (62 eyes). Eyes of the same patient were randomly assigned to the PPCCC group (18 right eyes and 13 left eyes) or group without PPCCC (NPCCC group). Eyes in both groups were implanted with a one-piece foldable hydrophobic acrylic IOL via routine cataract surgery. Patients in the PPCCC group underwent additional manual PPCCC before IOL implantation. Examinations were performed 1 day, 1 week, 1 month and 3 months postoperatively. IOL tilt (x, y), decentration (x, y), anterior chamber depth (z) and refractive prediction error data were collected and analyzed with Pentacam. Postoperatively, the range of IOL position change over 3 months in PPCCC group was comparable to NPCCC group, which indicated smaller value in every tilt and decentration index. PPCCC eyes showed comparable tilt and decentration with NPCCC eyes in this study endpoint: mean tilt (x, y), decentration (x, y) and anterior chamber depth (ACD) were 1.04 ± 0.56°, 0.90 ± 0.64°, 0.239 ± 0.140 mm, 0.233 ± 0.133 mm and 4.01 ± 0.32 mm, respectively, in the PPCCC group vs. 1.09 ± 0.76°, 1.10 ± 0.82°, 0.252 ± 0.153 mm, 0.244 ± 0.155 mm and 4.01 ± 0.38 mm, respectively, in the NPCCC group. Refractive prediction error in the PPCCC group demonstrated a mild hyperopic shift vs. the NPCCC group (0.13 ± 0.50 vs. 0.05 ± 0.39; p = 0.208), and corrected distance visual acuity (CDVA) did not differ between the two groups (0.027 ± 0.014 vs. 0.059 ± 0.185; p = 0.377). Comparable IOL tilt, decentration, ACD and refractive prediction error were observed in PPCCC eyes with that underwent routine cataract surgery. Little IOL position fluctuation and good visual acuity were shown in PPCCC group over time. Trail registration: The study was registered at the Chinese Clinical Trial Register Center on May 27th, 2020 (protocol code ChiCTR2000033304, 27/05/2020).

Tài liệu tham khảo

McKelvie J, McArdle B, McGhee C (2011) The influence of tilt, decentration, and pupil size on the higher-order aberration profile of aspheric intraocular lenses. Ophthalmology 118(9):1724–1731. https://doi.org/10.1016/j.ophtha.2011.02.025

Liu X, Xie L, Huang Y (2019) Effects of decentration and tilt at different orientations on the optical performance of a rotationally asymmetric multifocal intraocular lens. J Cataract Refract Surg 45(4):507–514. https://doi.org/10.1016/j.jcrs.2018.10.045

Lu C, Yu S, Song H, Zhao Y, Xie S, Tang X, Yuan X (2019) Posterior capsular opacification comparison between morphology and objective visual function. BMC Ophthalmol 19(1):40. https://doi.org/10.1186/s12886-019-1051-z

Placeres Dabán J, Elvira JC, Azrak C, Rial L, Piñero DP, Belda JI (2021) Long-term clinically significant posterior capsular opacification development pattern in eyes implanted with an aspheric monofocal intraocular lens with a square optic edge. J Ophthalmol 2021:4566436. https://doi.org/10.1155/2021/4566436

Uzel MM, Ozates S, Koc M, Taslipinar Uzel AG, Yılmazbaş P (2018) Decentration and tilt of intraocular lens after posterior capsulotomy. Semin Ophthalmol 33(6):766–771. https://doi.org/10.1080/08820538.2018.1443146

Ali M, Abdul Jabbar AB, Zahid MH, Jeeva I, Rehman Siddiqui MA (2022) YAG capsulotomy rates between two types of trifocal intraocular lenses. JPMA J Pak Med Assoc 72(6):1250–1254. https://doi.org/10.47391/JPMA.1782

Castaneda VE, Legler UF, Tsai JC, Hoggatt JP, Assia EI, Hogan C, Apple DJ (1992) Posterior continuous curvilinear capsulorhexis. An experimental study with clinical applications. Ophthalmology 99(1):45–50

Vasavada AR, Praveen MR, Tassignon M-J, Shah SK, Vasavada VA, Vasavada VA, Van Looveren J, De Veuster I, Trivedi RH (2011) Posterior capsule management in congenital cataract surgery. J Cataract Refract Surg 37(1):173–193. https://doi.org/10.1016/j.jcrs.2010.10.036

Ouchi M (2016) Primary posterior continuous curvilinear capsulorhexis combined with diffractive multifocal intraocular lens implantation. Eye (London, England) 30(1). https://doi.org/10.1038/eye.2015.201

Schojai M, Schultz T, Haeussler-Sinangin Y, Boecker J, Dick HB (2017) Safety of femtosecond laser-assisted primary posterior capsulotomy immediately after cataract surgery. J Cataract Refract Surg 43(9):1171–1176. https://doi.org/10.1016/j.jcrs.2017.06.041

Yu M, Yan D, Wu W, Wang Y, Wu X (2020) Clinical outcomes of primary posterior continuous curvilinear capsulorhexis in postvitrectomy cataract eyes. J Ophthalmol 2020:6287274. https://doi.org/10.1155/2020/6287274

Yu M, Huang Y, Wang Y, Xiao S, Wu X, Wu W (2021) Three-dimensional assessment of posterior capsule-intraocular lens interaction with and without primary posterior capsulorrhexis: an intraindividual randomized trial. Eye (London, England). https://doi.org/10.1038/s41433-021-01815-4

Madrid-Costa D, Ruiz-Alcocer J, Pérez-Vives C, Ferrer-Blasco T, López-Gil N, Montés-Micó R (2012) Visual simulation through different intraocular lenses using adaptive optics: effect of tilt and decentration. J Cataract Refract Surg 38(6):947–958. https://doi.org/10.1016/j.jcrs.2012.01.029

Li L, Wang K, Yan Y, Song X, Liu Z (2013) Research on calculation of the IOL tilt and decentration based on surface fitting. Comput Math Methods Med 2013:572530. https://doi.org/10.1155/2013/572530

Zhang F, Zhang J, Li W, Zhou L, Feng D, Zhang H, Fang W, Sun R, Liu Z (2020) Correlative comparison of three ocular axes to tilt and decentration of intraocular lens and their effects on visual acuity. Ophthalmic Res 63(2):165–173. https://doi.org/10.1159/000504716

Gu X, Chen X, Yang G, Wang W, Xiao W, Jin G, Wang L, Dai Y, Ruan X, Liu Z, Luo L, Liu Y (2020) Determinants of intraocular lens tilt and decentration after cataract surgery. Ann Transl Med 8(15):921. https://doi.org/10.21037/atm-20-1008

Wang L, Guimaraes de Souza R, Weikert MP, Koch DD (2019) Evaluation of crystalline lens and intraocular lens tilt using a swept-source optical coherence tomography biometer. J Cataract Refract Surg 45(1):35–40. https://doi.org/10.1016/j.jcrs.2018.08.025

Ning Y, Shao Y, Zhao J, Zhang J, Wang M, Qin Y (2021) Stability of various types of aspheric intraocular lenses after implantation: a one-year retrospective study. Int J Gen Med 14:2183–2190. https://doi.org/10.2147/IJGM.S301887

Cornaggia A, Clerici LM, Felizietti M, Rossi T, Pandolfi A (2021) A numerical model of capsulorhexis to assess the relevance of size and position of the rhexis on the IOL decentering and tilt. J Mech Behav of Biomed Mater 114:104170. https://doi.org/10.1016/j.jmbbm.2020.104170