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Influence of decentration and tilt of Tecnis ZCB00 on visual acuity and higher order aberrations

Eye volume 37, pages 1640–1645 (2023)Cite this article

Subjects

Abstract

Background/Objectives

To determine the influence of decentration and tilt of a pseudophakic aspheric intraocular lens (IOL) on visual acuity (VA) and higher-order aberrations (HOAs), and to analyze the agreement between pupil center/axis and iridocorneal angles center/axis when assessing IOL decentration and tilt.

Subjects/Methods

A prospective interventional case series study including thirty-three patients undergoing Tecnis ZCB00 (Abbott Medical Optics) implantation. IOL decentration and tilt with respect to two reference systems (pupil and iridocorneal angles centers/axes), in cartesian (X,Y) and polar (radius/tilt, polar angle/azimuth) coordinates, were assessed with optical coherence tomography. VA and internal and ocular HOAs were evaluated. Multiple linear regression models and intraclass correlation coefficient (ICC) were computed.

Results

IOL decentration only showed a significant effect on internal HOAs for \(Z_3^3\) (R2 = 0.20, P = 0.04). IOL decentration with respect to the pupil center showed a significant effect on ocular \(Z_3^{ - 3}\) (R2 = 0.18, P = 0.05), \(Z_3^1\) (R2 = 0.36, P = 0.001) and \(Z_4^{ - 4}\) (R2 = 0.24, P = 0.02); and with respect to the center of iridocorneal angles, on ocular \(Z_3^3\) (R2 = 0.21, P = 0.03), \(Z_4^2\) (R2 = 0.32, P = 0.003), primary coma (R2 = 0.41, P < 0.001), and coma-like (R2 = 0.40, P = 0.001). Poor agreement between both reference systems was found for IOL decentration measurements (ICC ≤ 0.41), except for the polar angle coordinate (ICC = 0.83). Tilt measurements showed good agreement (ICC ≥ 0.75).

Conclusions

Tecnis ZCB00 decentration and tilt values after uneventful implantation appear not to have influence on VA, and their effect on HOAs are not high enough to clinically affect quality of vision. Pupil and iridocorneal angles used as reference systems may be interchangeable for IOL tilt measurements, but not for decentration.

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Fig. 1: Segmentation of the swept-source optical coherence tomography image showing an implanted Tecnis® ZCB00.
Fig. 2: Polar plots of the decentration and tilt of the Tecnis® ZCB00 in relation to the pupil center or axis, and center or axis of iridocorneal angles.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

EM-P was supported by Junta de Castilla y León and European Social Fund (EDU/1100/2017). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Authors and Affiliations

  1. Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain

    Elena Martínez-Plaza, Alberto López-de la Rosa, Alberto López-Miguel & Miguel J. Maldonado

  2. Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain

    Elena Martínez-Plaza, Alberto López-Miguel & Miguel J. Maldonado

  3. Faculty of Health, University of Plymouth, Plymouth, UK

    Eleni Papadatou, Antonio J. Del Águila-Carrasco & Phillip J. Buckhurst

  4. Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, UK

    Nabil E. Habib

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  1. Elena Martínez-Plaza
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Contributions

Concept and design: EP, NEH, PJB. Acquisition, analysis, or interpretation of data: All authors. Methodological development and statistical analysis: EMP, EP, AJAC, ALR. Drafting of the paper: EMP, ALR, ALM, MJM. Critical revision of the paper for important intellectual content: All authors.

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Correspondence to Alberto López-Miguel.

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Competing interests

PJB reports grants from Bausch and Lomb, Zeiss and Medicontur outside the scope of the submitted work. The rest of the authors declare no competing interests.

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Martínez-Plaza, E., López-de la Rosa, A., Papadatou, E. et al. Influence of decentration and tilt of Tecnis ZCB00 on visual acuity and higher order aberrations. Eye 37, 1640–1645 (2023). https://doi.org/10.1038/s41433-022-02211-2

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