Effect of manual capsulorhexis size and position on intraocular lens tilt, centration, and axial position.

PURPOSE:To evaluate the influence of a manual capsulorhexis size, shape, and position on postoperative axial position, tilt, and centration of intraocular lenses (IOLs). SETTING:Hanusch Hospital, Vienna, Austria. DESIGN:Prospective cases series. METHODS:Patients had cataract surgery and had follow-ups 1 hour and 3 months after surgery. Postoperatively, patients were divided into 3 groups according to the capsulorhexis shape and size as follows: control, symmetrical capsulorhexis between 4.5 mm and 5.5 mm; small group, capsulorhexis smaller than 4.5 mm; and eccentric, all other capsulorhexes. At both follow-ups, a retroillumination image, partial coherence interferometry measurements, and Purkinje meter measurements were performed. RESULTS:This study comprised 255 eyes. The mean postoperative absolute anterior chamber depth shift in the control, eccentric capsulorhexis, and small capsulorhexis groups was 0.31 mm ± 0.27 (SD), 0.36 ± 0.24 mm, and 0.26 ± 0.24 mm, respectively (P = .419). The mean tilt in the control, eccentric capsulorhexis, and small capsulorhexis groups was 4.08 ± 2.13 degrees, 3.66 ± 2.04 degrees, and 2.82 ± 1.67 degrees, respectively (P = .370), and the mean decentration was 0.38 ± 0.23 mm, 0.40 ± 0.21 mm, and 0.17 ± 0.08 mm, respectively (P = .027). CONCLUSIONS:Capsulorhexis size and shape had little effect on the capsular bag performance of modern IOLs. Only eyes with a severely malformed capsulorhexis had a slightly decentered IOL.