Three-Dimensional Reconstruction and Swept-Source Optical Coherence Tomography for Crystalline Lens Tilt and Decentration Relative to the Corneal Vertex.

Purpose To investigate crystalline lens tilt and decentration with respect to the corneal vertex (CV) using swept-source optical coherence tomography (SS-OCT) combined with three-dimensional (3D) reconstruction. Methods Thirty consecutive patients with cataract (30 right eyes) were included in this prospective, observational, pilot case series study. SS-OCT anterior segment images and 3D reconstructions were used for data analysis. Results The mean distance between the central points of crystalline lens plane and limbus plane was approximately 0.33 ± 0.18 mm. The distance of the center of the limbus plane relative to the CV was approximately 0.31 ± 0.14 mm, which approximated the distance of the center of the crystalline lens plane relative to the CV at 0.33 ± 0.20 mm (P = 0.354). However, the centers of the limbus and crystalline planes were not in the same quadrant in 80% of eyes (24/30). Moreover, the crystalline lens tilted by approximately 4.16° ± 1.97° relative to the CV. Conclusions The center of the limbus plane was not consistent with that of the crystalline lens plane. The tilt and decentration of the crystalline lens were natural phenomena. Translational Relevance The SS-OCT technology combined with 3D reconstruction was useful for quantifying the tilt and decentration of the crystalline lens. The definition of angle alpha used for premium IOL screening should be updated.