Early dynamics of intraocular lens position: longitudinal analysis of decentration and tilt after surgery

To analyze the early dynamics of intraocular lens(IOLs) tilt and decentration within the first postoperative month and associated risk factors. This study included patients who underwent conventional phacoemulsification with IOL implantation. All patients underwent preoperative ophthalmic examinations. The tilt and decentration of IOLs were measured by the second-generation anterior segment optical coherence tomography (Casia2). Univariate and multivariate regression analyses were used to evaluate the relationship between tilt and decentration of IOLs and ocular biometric parameters(defined as tilt ≥ 7°and decentration ≥ 0.4 mm). A total of 192 patients (192 eyes) were included. 1 day, 1 week, and 1 month after the cataract surgery, there was no statistically significant difference in the tilt and decentration of IOLs (4.82 ± 2.08°vs4.91 ± 2.10°vs4.85 ± 2.08°and 0.23 ± 0.12mmvs0.22 ± 0.13mmvs0.23 ± 0.14 mm, all p > 0.05). Crystalline lens tilt(odds ratio [OR] = 2.08), age (OR = 1.07), Lens vault(LV)(OR = 4.52), lens thickness (LT) (OR = 3.48), anterior chamber depth (ACD) (OR = 0.17), white-to-white(WTW)(OR = 0.63) and anterior chamber width(ACW) (OR = 0.23) were associated with IOLs tilt exceeding 7 degrees (all P < 0.05). Crystalline lens tilt is an independent risk factor for clinically significant IOLs tilt. The IOLs demonstrated outstanding early stability within the capsule. The IOLs tilt magnitude was greater in patients with a larger age, crystalline lens tilt, LV, LT, and smaller ACD, WTW, and ACW. In these patients, premium IOLs should be implanted cautiously.