Rotational Stability Of A Toric Monofocal Intraocular Lens With An Extended Depth Of Focus

The axis alignment of a toric intraocular lens (IOL) is a critical parameter for its efficacy and the patient’s satisfaction with the surgical outcome. This study aims to evaluate the rotational stability of a new toric monofocal IOL, which additionally promises an improved postoperative intermediate visual acuity.

Vienna Institute for Research in Ocular Surgery (VIROS), a Karl-Landsteiner-Institute, Hanusch Hospital, Vienna

This prospective, unmasked, single-center study included 50 eyes of 50 patients with regular corneal astigmatism ≥ 0.75 diopters. The Tecnis Eyhance Toric II IOL (Johnson & Johnson Vision) was implanted in one eye of each study patient. Pictures of the alignment axis of the IOL were taken intraoperatively, one hour, one week, and 3 months after surgery. Autorefraction and subjective refraction as well as uncorrected and corrected distance (4 meters) and intermediate (66 cm) visual acuity were assessed at the 3-months visit. Furthermore, a Purkinje meter was used to measure tilt and decentration of the IOL at the last visit. Images where the IOL marks were not clearly visible due to poor pupil dilation were not included into the analysis.

An analysis of 27 eyes of 27 patients has shown the mean absolute change in IOL axis was 1.5+/-1.3° and 1.4+/-1.5° between the measurements 1 hour and 3 months postoperatively compared to intraoperative. No statistically significant difference could be detected in axis alignment between the mentioned timepoints. Three months after surgery 96% of IOLs rotated less than 5° and 100% of IOLs rotated less than 7° (n=27). The preoperative DCVA was 0.28+/-0.14 LogMar and -0.002+/-0.13 LogMar 3 months after surgery. Furthermore a significant reduction in refractive cylinder from 1.8+/-1.1dpt. preoperatively to 0.4+/-0.4 dpt. postoperatively at 3 months was observed. (Wilcoxon signed rank test, P < 0.0001, n=39).  

The preliminary results show excellent rotational stability with no significant difference from intraoperatively to 3 months postoperatively. A significant difference in DCVA and refractive cylinder was found between preoperatively and 3 months postoperatively. The final 3-months data of this study will be presented at the ESCRS congress.