Tilt and decentration of three-piece foldable high-refractive silicone and hydrophobic acrylic intraocular lenses with 6-mm optics in an intraindividual comparison

PURPOSE: Intraindividual comparison of tilt and decentration of three-piece foldable intraocular lenses (IOLs) with 6-mm optics and different edge design and material. DESIGN: Prospective randomized study. METHODS: Twenty-five patients with senile cataract (group I) received a foldable silicone, sharp optic edge IOL in one eye and a silicone, rounded optic edge IOL in the other eye. Group II (n = 28) received the foldable silicone, sharp optic edge IOL in one eye and an acrylate, sharp optic edge IOL in the other eye. Scheimpflug photography was performed after the procedure with an anterior eye segment analysis system. Tilt and decentration of the IOL optic were measured 1 week, 6 months, and 12 months after the procedure. RESULTS: In group I, the foldable silicone, sharp optic edge IOL showed a mean optic tilt of 3.03 +/- 1.79 degrees and an optic decentration of 0.24 +/- 0.13 mm; the silicone, rounded optic edge IOL showed a tilt of 3.26 +/- 1.69 degrees and a decentration of 0.23 +/- 0.13 mm. In group II, the foldable silicone, sharp optic edge IOL showed an average tilt of 2.34 +/- 1.81 degrees and a decentration of 0.29 +/- 0.21 mm after 12 months; the acrylate, sharp optic edge IOL had a tilt of 2.32 +/- 1.41 degrees and a decentration of 0.24 +/- 0.10 mm. There were no significant differences in either group. CONCLUSION: The examined IOLs showed a stable position regarding tilt and decentration in the first 12 postoperative months, independent of material and edge design. Slight deviations from the optical axis might affect the outcome in aspheric or multifocal IOLs.