To explore the risk factors and construct nomogram models to predict the risks of clinically significant intraocular lens (IOL) tilt and decentration after cataract surgery in age-related cataract patients.
Zhongshan ophthalmic center, Guangzhou, China.
Prospective cohort study.
A total of 207 patients (207 eyes) who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Casia2 was used to measure the tilt and decentration of crystalline lens and IOL before and 3 months after surgery. Univariate and multivariate logistic regression analyses were used to determine the risk factors of clinically significant IOL tilt and decentration, and nomogram prediction models were constructed according to the results of the multivariate logistic regression analysis.
Twenty-four eyes (11.59%) and 16 eyes (7.73%) had clinically significant IOL tilt and decentration at 3 months after cataract surgery. Multivariate logistic regression analysis revealed that preoperative crystalline lens tilt and decentration were the risk factors for clinically significant IOL tilt (OR=3.519, P<0.001) and decentration (OR=410.22, P=0.001), respectively. Axial length was another association factor for clinically significant IOL decentration (OR=2.155, P=0.019). The risk models demonstrated good calibrations and discriminations for the predictions of clinically significant IOL tilt (ROC area=0.833, cut-off value=6.5) and decentration (ROC area=0.757, cut-off value=0.08).
The good performances of our models suggested that they may be useful risk-prediction tools for postoperative IOL tilt and decentration. The measurement of preoperative crystalline lens tilt and decentration should be one of the routine examinations before cataract surgery, especially for toric and multifocal IOLs.