Scheimpflug Analysis of Centration and Bending of Posterior Chamber Phakic Intraocular Lenses

Asia Pac J Ophthalmol (Phila). 2014 May-Jun;3(3):136-40. doi: 10.1097/APO.0000000000000004.

Abstract

Purpose: The aim of the study was to present a novel technique for the assessment of postoperative centration and bending in phakic intraocular lens (PIOL), illustrated through 4 patient examples.

Design: This was a prospective observational study.

Methods: Four patients (7 eyes) who presented with complaints of reduced quality of vision after implantation with a Staar Collamer plate haptic PIOL were recruited for assessment. Scheimpflug images were obtained and analyzed with respect to the apical axis and the crystalline lens by means of an in-house-developed algorithm. The program provides an estimate for the PIOL centration and bending through an analysis of the distance between the PIOL and the crystalline lens.

Results: The algorithm detected PIOL bending in 5 of the 7 eyes and PIOL decentration in 3 eyes. The PIOL bending or decentration detected corresponded, in all cases, with the axis of the astigmatism-like complaints in the patient. In 2 eyes of the same patient, the analysis could not be performed because the distance between PIOL and crystalline lens was too short for reliable analysis.

Conclusions: This algorithm is a useful tool to objectively assess the postoperative complaints of patients implanted with a posterior chamber PIOL. Bending and decentration due to anatomical variations of the sulcus lens position can be measured and in many cases correlated with patients' complaints.