Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2025 Mar 1;51(3):196-203.
doi: 10.1097/j.jcrs.0000000000001585.

Assessing postoperative toric intraocular lens rotation: comparative analysis

Marcus Lisy  1 , Victor Danzinger, Markus Schranz, Nikolaus Mahnert, Claudette Abela-Formanek, Christina Leydolt, Rupert Menapace, Daniel Schartmüller
Affiliations
Clinical Trial

Assessing postoperative toric intraocular lens rotation: comparative analysis

Marcus Lisy et al. J Cataract Refract Surg. .

Abstract

Purpose: To investigate the accuracy of 3 distinct postoperative toric intraocular lens (TIOL) rotational stability measurement methods.

Setting: Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

Design: Single-center, prospective, interventional clinical trial.

Methods: 128 eyes of 81 patients with age-related cataract received a hydrophobic acrylic TIOL Clareon CNW0T3-9. To evaluate rotational stability, 3 distinct assessment methods were used: (Rotix) comparing the TIOL axis at the end of surgery (EoS) with 1 week and 6 months postoperatively using reference vessels at the sclera, (Slitlamp) comparing the intended axis (IA) with the axis at 1 week and 6 months using slitlamp photography using the horizontal axis as a reference, and (Casia) comparing the IA with the axis at 1 week and 6 months using the axis determination tool of a swept-source anterior segment optical coherence tomographer (Casia 2).

Results: Mean absolute rotation from EoS/IA to 6 months differed significantly among Rotix (1.33 ± 1.99 degrees [0.01; 19.80]), Casia (2.88 ± 2.64 degrees [0.00; 19.00]), and Slit-lamp (4.38 ± 3.38 degrees [0.02; 19.38]), as indicated by the Friedman test (χ 2 = 71.852, P < .001). Bland-Altman coefficients of repeatability (CoRs) indicated the closest agreement of results between Casia and Rotix, with a CoR of ±3.95 degrees, followed by Slit-lamp and Casia (±6.82 degrees), and finally, between Slit-lamp and Rotix (±7.19 degrees).

Conclusions: When assessing true TIOL rotational stability, it is imperative to use fixed anatomical landmarks as a reference and establish a baseline at the EoS. When assessing TIOL rotation along the horizontal axis, considering cyclorotation of the eye is crucial and must not be underestimated.

PubMed Disclaimer

References

    1. Kaur M, Shaikh F, Falera R, Titiyal J. Optimizing outcomes with toric intraocular lenses. Indian J Ophthalmol. 2017;65(12):1301–1313. doi: 10.4103/ijo.IJO_810_17 - DOI
    1. Tognetto D, Perrotta AA, Bauci F, Rinaldi S, Antonuccio M, Pellegrino FA, Fenu G, Stamatelatos G, Alpins N. Quality of images with toric intraocular lenses. J Cataract Refract Surg. 2018;44(3):376–381. doi: 10.1016/j.jcrs.2017.10.053 - DOI
    1. Chang DF. Early rotational stability of the longer Staar toric intraocular lens: fifty consecutive cases. J Cataract Refract Surg. 2003;29(5):935–940. doi: 10.1016/S0886-3350(02)01843-6 - DOI
    1. Lee BS, Chang DF. Comparison of the rotational stability of two toric intraocular lenses in 1273 consecutive eyes. Ophthalmology. 2018;125(9):1325–1331. doi: 10.1016/j.ophtha.2018.02.012 - DOI
    1. Singh A, Kapoor G, Baranwal VK, Kalra N. Rotational stability of Toric intraocular lenses. Med J Armed Forces India. 2022;78(1):68–73. doi: 10.1016/j.mjafi.2020.03.014 - DOI

LinkOut - more resources