Repositioning Rates of Toric IOLs Implanted in Cataract Surgery Patients: A Retrospective Chart Review

Abstract

Purpose: To determine the incidence of postoperative repositioning of toric intraocular lenses (IOLs) due to clinically significant rotation.

Patients and methods: This study included consecutive cataract patients with pre-existing astigmatism who had undergone cataract surgery with toric IOL implantation by a single experienced surgeon. Case records of patients who were recommended to undergo toric IOL repositioning surgery due to clinically significant postoperative IOL rotation from the implanted axis were identified. The need for a secondary intervention to manage residual astigmatism was based upon postoperative residual astigmatic error ≥0.75 D, the patient's qualitative dissatisfaction with the level of postoperative distance vision, dilated post-op examination, and confirmation of the significant potential for astigmatism reduction.

Results: Case records of 993 eyes implanted with AcrySof toric (N = 362), Tecnis Toric I (N = 53), Tecnis Toric II (N = 308), or enVista Toric IOLs (N = 270) were included. Postoperative toric IOL repositioning was recommended in 16 eyes (1.6%). The repositioning rate was highest in the eyes implanted with Tecnis Toric I (5.7%), followed by AcrySof Toric (2.2%), enVista Toric IOLs (1.1%), and Tecnis Toric II (0.6%).

Conclusion: This real-world analysis of eyes implanted with toric IOLs revealed that the rate of surgical IOL repositioning due to clinically significant IOL rotation was lower than 2% for enVista and Tecnis Toric II IOLs. When needed and with appropriate planning, toric IOL repositioning can be very successful.

Keywords: IOL repositioning; IOL rotation; Toric IOLs; astigmatism; rotational stability.

Figure 1

Proportion of eyes that underwent toric IOL repositioning due to clinically significant IOL rotation postoperatively (Statistically significant p-values are displayed; other comparisons had p>0.05 and are not displayed).