IOL tilt and decentration: a comparison of different haptic designs using CNN and SS-OCT in a short term

TL;DR

This study compares how two types of intraocular lenses (IOLs) stay in place after cataract surgery using advanced imaging and AI, finding that one design is more stable.

Contribution

A novel combination of SS-OCT and a customized CNN algorithm is used to analyze IOL tilt and decentration in different haptic designs.

Findings

Plate-haptic IOLs showed significantly less decentration compared to C-loop IOLs.

Both IOL types exhibited similar tilt, with a common inferotemporal tilt pattern.

Crystalline lens tilt was correlated with IOL tilt in both groups.

Abstract

To investigate the tilt and decentration differences and influencing factors of intraocular lenses (IOLs) with plate-haptic and C-loop haptic designs one month after cataract surgery, using the combination of swept-source optical coherence tomography (SS-OCT) and a customized convolutional neural network (CNN) algorithm.

Participants were categorized into two groups based on the haptic design of their implanted IOLs. Group A included 37 patients (37 eyes) with the ATTORBI 709 M plate-haptic design, while Group B comprised 42 patients (42 eyes) with the PY-60 AD C-loop design. SS-OCT examinations were performed both before and one month after cataract surgery. A customized CNN algorithm was developed to generate data for IOL tilt and decentration, using the corneal vertex as a reference.

This study included 79 patients (79 eyes). Before surgery, there were no statistically significant differences in ocular parameters between the two groups (all p > 0.05). Significant difference in IOL decentration was observed (Group A & Group B: 0.16 ± 0.08 mm & 0.42 ± 0.28 mm, p < 0.001). In contrast, the difference in IOL tilt was not significant (Group A & Group B: 4.60 ± 1.27° & 4.63 ± 1.93°, p = 0.948). Both groups displayed a predominant inferotemporal tilt of the crystalline lens and IOL, but decentration did not show a distinct distribution pattern. Multivariate linear regression confirmed a correlation between IOL tilt in both groups and crystalline lens tilt (p < 0.003).

The plate-haptic design IOL shows less decentration than the C-loop design. Clinicians should consider this potential difference in IOL stability when selecting IOLs with varying haptic designs.

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