Decentration of intraocular lenses implanted after intercapsular cataract extraction (envelope technique)

Pseudophakos decentration produces symptoms such as glare, halos, and other visual aberrations. We have reviewed 161 eyes of patients who had an intercapsular cataract extraction with intraocular lens (IOL) implantation with a follow-up of at least six months. Mean decentration was 0.54 mm. It was 0.46 mm for the lenses implanted symmetrically in the bag, 0.65 mm for those implanted in the sulcus, and 0.91 mm for those implanted asymmetrically (bag-sulcus). The differences between the lenses fixated in the bag and those asymmetrically situated were statistically significant (P less than .001). Circular looped lenses (360-degree encircling loop) decentered less (mean 0.28 mm) than modified C-loop lenses (mean decentration 0.63 mm) and modified J-loop lenses (mean decentration 0.60 mm). These differences were statistically significant (P less than .001). The differences were also significant if we considered only the lenses implanted in the bag (mean decentration 0.20 versus 0.59 and 0.54, respectively) (P less than .0001).