Influence of intraocular lens tilt and decentration on wavefront aberrations

Purpose: To investigate the influence of intraocular lens (IOL) tilt and decentration on higher-order aberrations (HOAs) using wavefront analysis. Setting: Department of Ophthalmology, Nara Medical University, Nara, Japan. Methods: Forty eyes of 40 patients with a 5.5 mm optic, foldable acrylic IOL were examined 4 to 48 months postoperatively. Ocular wavefront aberrations of the central 4.0 mm aperture diameter were measured using a Hartmann-Shack aberrometer. Higher-order aberrations from the 3rd to 4th order were calculated using Zernike polynomials. The relationship between IOL tilt and decentration, measured with a Scheimpflug camera, and ocular HOAs were investigated. Results: The correlation between IOL tilt and coma-like aberrations was significant (r = 0.431, Spearman rank correlation coefficient; P = .007). However, the correlation between IOL tilt and the spherical-like and total aberrations was not significant (P>.05), nor was the correlation between IOL decentration and coma-like, spherical-like, and total aberrations (P>.05). Conclusions: Intraocular lens tilt influenced ocular coma-like aberrations. The quality of the retinal image may improve by reducing IOL tilt.