Abstract: In the refractive cataract surgery, intraocular lens (IOL) has been developed from traditional spherical surface to aspherical design, and functional IOL with astigmatism correction and presbyopia correction met the different needs of cataract patients, but their tolerance to decentration and tilt is reduced. The IOL with 0 μm spherical aberration is well tolerant of displacement, and the influence of decentration and tilt on the visual quality of aspheric IOL is related to its spherical aberration correction ability and diopter. And the larger negative spherical aberration and the higher diopter of IOL, the greater impact is. Decentration and tilt are part of the sources of errors in the calculation of toric IOL degree, which will reduce its astigmatism correction ability and even cause new astigmatism, resulting in unpredictable visual functional results. Due to the more complex optical design and the division of near-sight and far-sight optical regions of presbyopia correction IOL, decentration and tilt have greater influence on its optical performance and are more prone to cause visual interference. In this article, the effects of decentration and tilt on the visual quality of different types of functional IOLs were reviewed to provide reference for clinical practice. (Int Rev Ophthalmol, 2022, 46:  512-516)

Key words: intraocular lens, decentration, tilt, visual quality