Clinicopathologic Study of the Effect of Radial Tears and Loop Fixation on Intraocular Lens Decentration

Purpose: The purpose of this study is to determine the effect of loop fixation and anterior capsular tears on intraocular lens (IOL) decentration. Methods: A retrospective measurement of IOL decentration was performed on 144 human eyes with posterior chamber (PC) IOLs obtained after death. Results: Decentration in eyes with asymmetrical bag-sulcus fixation (mean ± standard deviation, 0.64 ± 0.39 mm) was significantly higher than eyes with symmetrical fixation. In the presence of radial tears, symmetrically fixated IOLs in either the capsular bag or the ciliary sulcus decentered to a similar degree, 0.35 ± 0.25 mm and 0.4 ± 0.26 mm, respectively. The least decentration was observed with capsular fixation and no radial tears (0.18 ± 0.09 mm). This was significantly less decentration than with any other form of fixation in the presence of radial tears. Conclusion: This study shows that capsular fixation with no radial tears, as can be achieved by using the continuous curvilinear capsulorhexis, is associated with the least decentration.