Evaluation of Dynamic Intraocular Lens Movement Using Anterior Segment Optical Coherence Tomography Movie Analysis.

PURPOSE: To introduce a method to quantitatively assess dynamic intraocular lens (IOL) positioning using anterior segment optical coherence tomography (AS-OCT).

METHODS

This retrospective observational study analyzed 13 eyes with in-the-bag IOL fixation between May and December 2023 at the Ophthalmology Department of The Jikei University School of Medicine Hospital in Tokyo. Using ASOCT imaging during horizontal eye movements, dynamic IOL and iris movement angles were quantitatively assessed, compared with conventional static IOL tilt and decentration, and their interrelations were examined.

RESULTS

Static measurements revealed an average IOL tilt of 4.1 ± 1.3 degrees (range: 1.9 to 5.9 degrees) and decentration of 0.17 ± 0.10 mm (range: 0.02 to 0.38 mm). Dynamic analysis showed IOL movement angles of 2.6 ± 2.1 degrees (range: 0.3 to 7.3 degrees) and iris movement angles of 4.1 ± 3.4 degrees (range: 0.3 to 10.3 degrees). No correlation was found between the dynamic IOL movement angle and static IOL tilt and decentration, with some cases showing discrepancies (Spearman's rank correlation, P > .05). However, a strong positive correlation was observed between the dynamic IOL and iris movement angles (Spearman's rank correlation, R = 0.83, P < .05).

CONCLUSIONS

Although the static IOL tilt and decentration were within normal ranges, significant oscillations in IOL positioning were detected, highlighting the importance of dynamic assessment for evaluating IOL stability during daily activities. This study underscores the potential value of dynamic evaluation of IOL position in routine clinical practice. [J Refract Surg. 2025;41(5):e444-e450.].