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. 2020 Dec 16:14:4379-4384.
doi: 10.2147/OPTH.S285818. eCollection 2020.

Rotation Characteristics of Three Toric Monofocal Intraocular Lenses

Brent A Kramer  1 , David R Hardten  2 , John P Berdahl  3
Affiliations

Rotation Characteristics of Three Toric Monofocal Intraocular Lenses

Brent A Kramer et al. Clin Ophthalmol. .

Abstract

Purpose: To evaluate the rotational stability of the three monofocal toric intraocular lenses (IOLs) via data from an online toric IOL back-calculator.

Methods: A retrospective data review of an online toric IOL back-calculator, which allows users to input preoperative toric planning information, postoperative lens orientation, and subjective refraction. Inputted data were used to determine the optimal orientation of the toric IOL to minimize residual refractive astigmatism. Aggregate data from 3/11/2019 to 3/10/2020 were extracted and validated. Only data with ≥0.5D of residual refractive astigmatism were used in the study. Pre-operative intended IOL orientation and post-operative IOL orientation were used to calculate IOL rotation.

Results: After validation, 5397 entries were determined to represent patient eyes, of which 3238 represented the three monofocal IOLs evaluated. The rate of rotation for AcrySof, TECNIS, and enVista Toric IOLs was 72.7%, 83.4%, and 83.0%, respectively, and location only significantly impacted TECNIS IOLs. The magnitude of rotation for rotated IOLs was similar for all models and was significantly more for IOLs initially placed in the oblique axis. All IOL models tended to rotate in a counterclockwise direction (53.2%, 73.0%, 69.7%, respectively; p<0.05), and the tendency was greater for IOLs initially located horizontally.

Conclusion: The AcrySof IQ Toric IOL was more rotationally stable than both the TECNIS and enVista Toric IOLs; there was no significant difference in rotational stability of the latter two.

Keywords: AcrySof; TECNIS; astigmatism; enVista; rotation.

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Conflict of interest statement

All authors receive grant funding from Alcon Vision LLC. David R Hardten and John P Berdahl are owners of Ocular Surgical Data LLC. John P Berdahl receives personal fees from Alcon Vision LLC, Johnson & Johnson, and Bausch & Lomb. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Box and whisker plot of the magnitude of rotation for each IOL model. Only IOLs which rotated ≥5° were considered in this subset analysis. ANOVA showed no statistical difference between the three groups when considered as a whole (p=0.176). A two-tailed, equal variance Student’s t-test was performed and showed no difference when comparing the groups head-to-head. (AcrySof v. TECNIS p=0.126; AcrySof v. enVista p=0.191; TECNIS v. enVista p=0.513).
Figure 2
Figure 2
Stacked bar graph of the direction of rotation. A one-proportion z-test was performed with the expected amount of IOLs rotating counterclockwise set at 50%. * denotes groups which were statistically different (p<0.05).
Figure 3
Figure 3
Box and whisker plot of the magnitude of rotation stratified by IOL model and intended IOL location. Via ANOVA, the intended IOL location effected magnitude significantly in the AcrySof (p=0.0415) and TECNIS (p<0.001) groups, but not the enVista group (p=0.382). This was largely due to the increased magnitude of rotation for IOLs located obliquely, and there were only 17 enVista entries in this subset.
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