Prediction of postoperative intraocular lens tilt using swept-source optical coherence tomography

PURPOSE: To compare crystalline lens tilt in eyes before and intraocular lens (IOL) tilt in eyes after cataract surgery using swept-source optical coherence tomography (SS-OCT) (IOLMaster 700). SETTING: Hanusch Hospital, Vienna, Austria. DESIGN: Prospective case series. METHODS: Patients' eyes were scanned 1 week before and 2 months after cataract surgery with IOL implantation using an SS-OCT device. This device performs B-scans along 6 meridians (0, 30, 60, 90, 120, and 150 degrees) to determine lens and IOL tilt. RESULTS: Sixty-two eyes (62 patients) were included in the analysis. The mean magnitude and direction of tilt showed mirror symmetry between both eyes along the vertical axis and a primarily nasal outward tilt for right eyes and left eyes. The mean tilt was 4.3 degrees at 15.8 degrees preoperatively and 6.2 degrees at 16.8 degrees postoperatively. The mean direction of crystalline lens tilt preoperatively and IOL tilt postoperatively showed a strong correlation (R = 0.71), whereas the mean magnitude of tilt showed a weaker correlation (R = 0.37). The direction and magnitude of tilt of the crystalline lens and IOL eyes were normally distributed around similar values before and after surgery. CONCLUSIONS: The correlations between crystalline lens tilt and IOL tilt using whole-eye scanning indicate that preoperative tilt determination using SS-OCT could help predict postoperative IOL tilt, assist in IOL (toric) power calculations, and potentially improve visual outcomes.