ESCRS - PO235 - Utilizing Wavefront Aberrometry And Scheimpflug Imaging For The Assessment Of Intraocular Lens Tilt And Decentration

Utilizing Wavefront Aberrometry And Scheimpflug Imaging For The Assessment Of Intraocular Lens Tilt And Decentration

Published 2022 - 40th Congress of the ESCRS

Reference: PO235 | Type: ESCRS 2022 - Posters | DOI: 10.82333/fxhv-ja78

Authors: Cristina Tan* 1 , Victor Caparas 1

1Eye and Vision Institute,The Medical City,Pasig City,Philippines

Purpose

To present a case where we highlight the use of Wavefront Aberrometry and Scheimpflug Imaging to elucidate the presence of intraocular lens tilt and decentration.

Setting

The Eye and Vision Institute at The Medical City, Pasig, Philippines

Methods

A 48 year-old female underwent uneventful phacoemulsification surgery bilaterally with in-the-bag implantation of Extended Depth of Focus (EDOF) aspheric intraocular lens (MiniWell Toric SIFI, Italy).

10 months later, she experienced deterioration of vision on the right eye, seeing multiple shadows around objects (UCVA 20/60, BCVA 20/50). Slit lamp examination revealed an in-the-bag intraocular lens with the presence of a mild posterior capsular fibrosis with vertically oriented striae. Macular OCT was unremarkable.

The iTrace aberrometer (Tracey Technologies, USA) was used to further evaluate for the presence of aberrations along with Scheimpflug Imaging using Pentacam AXL Wave (OCULUS, Germany) to determine the extent of the IOL tilt. 

Results

The iTrace aberrometer revealed the presence of high internal and total eye aberrations confirming slit lamp examination findings. Scheimpflug Imaging also  confirmed the presence of IOL tilt secondary to posterior capsular fibrosis.

A YAG-capsulotomy of the posterior fibrosis was performed. One week later, the patient noted vast improvement in her vision (UCVA of 20/15-2) with the disapperance of previously noted shadows.        

Conclusions

Fibrotic changes on the posterior capsule can affect IOL position, leading to decentration, tilt and visual disturbances. Wavefront aberration and Scheimpflug Imaging objectively identify subtle changes in IOL placement to help elucidate patients' visual symptoms.