Quantification of physiological tilt of the phakic eye using biometry parameters and AS-OCT

PURPOSE: To comprehensively evaluate the tilt of the crystalline lens in phakic eyes and its relationship with optical biometry parameters.

SETTING: The retrospective analysis was conducted at the Department for Ophthalmology and Optometry, Kepler University Clinic, in Linz, Austria.

DESIGN: Lens tilt assessment was performed through a combined analysis of optical biometry (IOLMaster 700) and anterior segment optical coherence tomography (AS-OCT) data to understand its relationship.

METHODS: The study analyzed preoperative biometry data and AS-OCT images from 4689 eyes of 2489 patients before cataract surgery. The optical biometry parameters were correlated with the degree of lens tilt using logistic regression and machine learning techniques.

RESULTS: The mean lens tilt was 4.9 degrees, with 6.7% of eyes showing a tilt greater than 7 degrees. Significant associations were found with specific biometry parameters, such as anterior chamber depth, axial length, equator thickness, and lens decentration. The developed predictive model for assessing tilt risk demonstrated a high accuracy with an area under the curve of 0.862.

CONCLUSIONS: The findings highlight the mean lens tilt of 4.9 degrees in a cataract patient cohort. This analysis contributes to a broader understanding of lens orientation and its interactions with biometric parameters.