To evaluate the effects of continuous curvilinear capsulorhexis, intraocular lens (IOL) decentration and tilt on postoperative clinical outcomes after cataract surgery.

We reviewed 62 eyes of 52 patients who underwent cataract surgery and measured the uncorrected visual acuity, best corrected visual acuity and manifest refraction preoperatively and 3 months postoperatively. IOL decentration on anterior segment photography and IOL tilt on anterior optical coherent tomography were analyzed and correlations of postoperative uncorrected visual acuity, best corrected visual acuity, and higher order aberrations were evaluated. In addition, we inspected the relationship of size and decentration of continuous curvilinear capsulorhexis (CCC) intraoperatively with the change in IOL position postoperatively.

The average size of CCC was 5.40 ± 0.51 mm (4.12-6.24 mm) and the average decentration of CCC was 0.30 ± 0.19 mm (0.09-1.21 mm) intraoperatively. The average decentration of IOL was 0.23 ± 0.15 mm (0.00-0.71 mm) and the average IOL tilt was 1.43 ± 0.73° (0.00-4.22°) postoperatively. Intraoperative CCC size and decentration were associated with postoperative IOL decentration ( p = 0.01, p < 0.001), but not with IOL tilt ( p = 0.69, p = 0.52). There were no significant correlations between IOL decentration and tilt with postoperative visual outcomes and higher order aberrations.

The CCC size and decentration can affect the IOL decentration, but IOL decentration and tilt do not have a significant impact on clinical outcomes after cataract surgery.