PURPOSE

To investigate the occurrence and risk factors of clinically significant intraocular lens (IOL) decentration and tilt in highly myopic eyes using swept-source anterior segment optical coherence tomography (SS-AS-OCT).

DESIGN

Cross-sectional study.

METHODS

This study included 334 participants (334 eyes) with high myopia, defined as axial length (AL) ≥26 mm, who underwent phacoemulsification with IOL implantation. Decentration and tilt of IOL were assessed by SS-AS-OCT. Clinically significant IOL decentration and tilt was defined as decentration ≥0.4 mm and tilt ≥7°. Routine preoperative and postoperative examinations included visual acuity, refraction, biometric measurement using IOLMaster 700 (Carl Zeiss Meditec), and objective visual quality evaluated by OPD-Scan III (Nidek Technologies).

RESULTS

Among the 334 highly myopic participants, 71 (21.3%) had clinically significant IOL decentration, and 26 (7.78%) had clinically significant IOL tilt. The proportion of clinically significant IOL decentration (37.1% vs 14.0%, P < .001) and tilt (16.2% vs 3.90%, P < .001) in those with AL ≥30 mm was significantly higher than in those with AL <30 mm. The multivariable logistic regression model showed only AL ≥30 mm was associated with clinically significant IOL decentration (odds ratio, 1.65; P = .002). AL ≥30 mm (odds ratio, 2.09; P = .001) was an independent risk factor for clinically significant IOL tilt after adjusting for confounders. AL ≥30.3 mm could effectively predict IOL decentration ≥0.6 mm (area under the curve, 0.802).

CONCLUSIONS

Participants with AL >30 mm have a higher risk of clinically significant IOL decentration and tilt, thus caution should be taken to implant multifocal or toric IOL for these patients.

中文翻译：

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高度近视眼中具有临床意义的人工晶状体偏心和倾斜：扫描源光学相干断层扫描研究

目的

应用扫描源眼前节光学相干断层扫描（SS-AS-OCT）研究高度近视眼中具有临床意义的人工晶状体（IOL）偏心和倾斜的发生及危险因素。

设计

横断面研究。

方法

这项研究包括 334 名高度近视的参与者（334 只眼），定义为眼轴长度（AL）≥26 毫米，他们接受了人工晶状体植入的超声乳化术。IOL 的偏心和倾斜通过 SS-AS-OCT 进行评估。具有临床意义的 IOL 偏心和倾斜定义为偏心≥0.4 mm 和倾斜≥7°。常规术前和术后检查包括视力、屈光度、使用 IOLMaster 700 (Carl Zeiss Meditec) 进行的生物特征测量，以及通过 OPD-Scan III (Nidek Technologies) 评估的客观视觉质量。

结果

在 334 名高度近视的参与者中，71 名（21.3%）有临床上显着的 IOL 偏心，26 名（7.78%）有临床上显着的 IOL 倾斜。AL ≥ 30 mm的临床显着IOL 偏心（37.1% vs 14.0%，P < .001）和倾斜（16.2% vs 3.90%，P < .001）的比例显着高于AL <30毫米。多变量逻辑回归模型显示，只有 AL ≥30 mm 与临床上显着的 IOL 偏心相关（优势比，1.65；P  = .002）。在调整混杂因素后，AL ≥30 mm（优势比，2.09；P  = .001）是临床显着 IOL 倾斜的独立危险因素。AL ≥30.3 mm 可有效预测 IOL 偏心≥0.6 mm（曲线下面积，0.802）。

结论

AL > 30 mm 的参与者具有更高的临床显着 IOL 偏心和倾斜的风险，因此应谨慎为这些患者植入多焦点或复曲面 IOL。