Decentration of 3-piece versus plate-haptic silicone intraocular lenses

Purpose: To compare the incidence of decentration with 2 types of silicone intraocular lenses (IOLs). Setting: John A. Moran Eye Center, University of Utah Medical Center, Salt Lake City, Utah, USA. Methods: Selection criteria for this retrospective study included patients who had uncomplicated cataract surgery with a clear cornea or scleral tunnel incision with a curvilinear capsulorhexis and capsular bag implantation of a silicone IOL. After a mean follow-up of 14 months (range 12 to 18 months), 54 eyes implanted with a 3-piece lens (AMO SI-30) and 58 eyes implanted with a plate-haptic lens (Staar AA403) were examined for posterior chamber IOL decentration. The decentration criterion was 0.5 mm or more from the center of the pupil. Detailed chart review of preoperative and postoperative measurements was performed for each patient. Results: Eighteen of the 3-piece IOLs (33%) and 11 of the plate-haptic IOLs (20%) were decentered 0.5 mm or more (P = .129). Using photographic analysis, the mean IOL decentration with the 3-piece IOL (1.12 mm +/- 0.198 [SD]) was significantly greater than with the plate-haptic IOL (0.632 +/- 0.278 mm) (P < .001). No statistically significant correlation was found between the centered or decentered IOL groups' preoperative refraction, axial length, capsulorhexis size, type of incision, or rate of neodymium:YAG laser capsulotomy. Conclusions: No statistically significant difference was seen between the decentration rates of 3-piece and plate-haptic IOLs; however, the amount of decentration with the 3-piece IOL was significantly greater than with he plate-haptic IOL. Other factors did not contribute to IOL decentration.