Therefore, their impact on postoperative visual quality cannot be underestimated and require intensive studies. This implies that they are very common, causing an obstacle in refractive cataract surgery.
Statistically, 10% of patients have IOL tilt and decentration greater than 5° and 0.5 mm, respectively, after cataract surgery. Large aberrations are induced with less than 0.5 mm of decentration, leading to noticeable visual symptoms. However, clinical statistics show that human eyes are very sensitive to IOL tilt and decentration. However, more than 5° of tilt or more than 1 mm of decentering causes substantial visual loss. Studies have shown that an IOL with up to 2 – 3 tilt and 0.2 mm – 0.3 mm decentration does not disturb the image quality. They restrain the peripheral part from casting an image on the retina, resulting in glare, astigmatism, visual halo, and monocular diplopia. Tilt and decentration of intraocular lens (IOL) commonly cause visual quality deterioration after cataract surgery. 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. This is the first review that compares the effect of IOL tilt and decentration on image quality for various IOL designs. Additionally, its tilt and decentration have less impact on the vision than bifocal and trifocal IOL.
An extended depth of focus IOL can achieve good visual acuity in the distant, intermediate, and near range.
The image quality enhances or deteriorates in the direction of the decentered IOL. The optical quality of asymmetric multifocal IOLs varies significantly after decentration and tilt in different directions. Furthermore, the optical performance of toric IOLs with an accurate axis remains stable irrespective of tilt and decentration. Aspherical IOLs are more sensitive to decentration or tilt than spherical IOLs. Moreover, the tilt and decentration of 1-piece IOL are less correlated with internal ocular HOAs than those of 3-piece IOL. Multiple factors affect IOL tilt and decentration in the pre-, mid-, and post-operation phases. We find that tilt and decentration of intraocular lens (IOL) commonly cause visual quality deterioration after cataract surgery.
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