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. 2025 Apr 23:19:1345-1355.
doi: 10.2147/OPTH.S522728. eCollection 2025.

Comparing Rotational Stability Over Time Between Four Monofocal Toric Intraocular Lenses

Peter Hoffmann  1 , Richard Potvin  2 , Robert D Anello  3 , Fritz Hengerer  4 , Gerd Auffarth  5 , Yves Guldenfels  6 , Eckart Bertelmann  7 , Ramon Ruiz Mesa  8 , Isaak Fischinger  9 , Sandra Krawczyk  10 , Berthold Seitz  11 , David Antolin-Garcia  12 , Stefanie Schmickler  13 , Louis Hoffart  14 , Thomas Kohnen  15 , Alvin S Relucio  3
Affiliations

Comparing Rotational Stability Over Time Between Four Monofocal Toric Intraocular Lenses

Peter Hoffmann et al. Clin Ophthalmol. .

Abstract

Purpose: To evaluate the rotational stability of four different monofocal toric intraocular lenses (IOLs) from surgery to 4-6 months postoperative.

Methods: This was a subset of data from a prospective multi-center randomized clinical study. High resolution retro-illuminated images of eyes implanted with four different toric IOLs were obtained immediately after surgery, and at 1 day, 1 week, 1 month and 4-6 months after surgery. Fixed scleral features were identified in the surgical image. An independent reading center evaluated the orientation of the IOL from all images, based on the angle between the toric axis marks and these fixed scleral landmarks. Rotational stability was determined by calculating differences in orientation between visits.

Results: Digital images from 299 eyes implanted with one of the four IOLs were available for analysis. Orientation data were successfully determined in about 90% of images. Biometry and IOL orientation were not significantly associated with IOL rotation. The Vivinex lens showed the lowest absolute rotation, with a mean value less than 1.5 degrees at all time intervals measured, with a maximum standard deviation of 1.4 degrees. The AcrySof lens was next lowest, with an absolute rotation below two degrees for all intervals. Mean absolute rotation for the Tecnis lens was significantly higher than for the other IOLs (>2 degrees for all intervals). For the AcrySof and Vivinex lenses, there were no reported rotations >10 degrees for any interval; 97% or more of results were <5 degrees, compared to 93% for the AT Torbi lens and 90% for the Tecnis lens. Only 6 lenses (4 Tecnis: 8.3%, 2 AT Torbi: 4.3%) had a rotation > 10 degrees at any time point.

Conclusion: Rotational stability appeared excellent for the Vivinex and AcrySof toric IOLs, with slightly more variable performance evident with the AT Torbi and Tecnis IOLs.

Keywords: AT Torbi™; AcrySof™ SN6ATx; Astigmatism; Tecnis™ Toric ZCT; Vivinex™; XY1-SP; XY1A; rotation; toric.

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Conflict of interest statement

Richard Potvin is a consultant to Alcon and HOYA. Robert Anello and Alvin S Relucio are employees of HOYA Surgical Optics. Gerd Auffarth reports grants and/or personal fees from Afidera, Alcon, AMO/Johnson&Johnson, Carl Zeiss Meditec, Contamac, Cristalens, Eyebright, Eyedeal, Hanita, Hoya, Oculus, Presbia, Rayner, Teleon, and 1stQ, outside the submitted work. Prof. Dr. Thomas Kohnen reports grants from University Clinic Frankfurt, during the conduct of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Scatterplot of absolute rotation (surgery to 1 week) by axial length, Vivinex IOLs.
Figure 2
Figure 2
Scatterplot of absolute rotation (surgery to 1 week) by IOL sphere power, Vivinex IOLs.
Figure 3
Figure 3
Mean calculated absolute rotation from baseline at each time period by IOL type.
Figure 4
Figure 4
Box-whisker plot of the absolute rotation calculated between the surgical and 1-day visits by IOL.
Figure 5
Figure 5
Box-whisker plot of the absolute rotation calculated between the surgical and 1-week visits by IOL.
Figure 6
Figure 6
Box-whisker plot of the absolute rotation calculated between the 1 month and 4–6 month visits by IOL.
See this image and copyright information in PMC

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