Short-term Dynamics after Single- and Three-piece Acrylic Intraocular Lens Implantation: A Swept-source Anterior Segment Optical Coherence Tomography Study

Abstract

Accurate alignment of an intraocular lens (IOL) is indispensable for achieving accurate postoperative refractive outcomes. Thus, we evaluated decentration and tilt of single- and three-piece IOLs, as well as anterior chamber depth (ACD), at 3 hours, 24 hours, 2 weeks, and 4 weeks after cataract surgery, using swept-source anterior segment optical coherence tomography. There was no significant difference in postoperative visual acuity between eyes with single- or three-piece IOLs. Absolute values of IOL decentration at 24 hours and 2 weeks after surgery were significantly larger (P = 0.008 and 0.046, respectively) in eyes with the single-piece IOL than in those with the three-piece IOL. Both single- and three-piece IOLs tended to tilt toward the inferotemporal direction; however, there was no significant difference in the absolute values of IOL tilt at any postoperative time point. ACD at 24 hours after surgery was significantly deeper (P = 0.009) in eyes with the three-piece IOL, compared with eyes with the single-piece IOL. Therefore, although both single- and three-piece IOL locations varied transiently after surgery, IOL locations were similar between both IOLs at 4 weeks after surgery and were not associated with any statistical difference in visual function.

Figure 1

Decentration of single- and three-piece intraocular lenses (IOLs) at 3 hours, 24 hours, 2 weeks, and 4 weeks after surgery. Coordinate graphics on the right and left sides show IOL decentration in the left and right eyes, respectively.

Figure 2

Tilt of single- and three-piece intraocular lenses (IOLs) at 3 hours, 24 hours, 2 weeks, and 4 weeks after surgery. Coordinate graphics on the right and left sides show IOL tilt in the left and right eyes, respectively.

Figure 3

Anterior chamber depth (ACD) changes after single-piece and three-piece intraocular lens implantation. The abscissa represents perioperative time points and the ordinate represents ACD. Statistical analyses were performed using the Friedman repeated measures analysis of variance on ranks, followed by Dunnett’s method (*P < 0.05).

Figure 4

Spherical equivalent (SE) changes before and after single- and three-piece intraocular lens implantation. The abscissa represents perioperative time points and the ordinate represents the SE. Statistical analyses were performed using the Friedman repeated measures analysis of variance on ranks, followed by Dunnett’s method (*P < 0.05).