Rotational Stability Of Toric Intraocular Lens After Combined Phakovitrectomy: A Case Series

To assess postoperative rotational stability and refractive astigmatism after combined phacovitrectomy with implantation of a toric intraocular lens (IOL) with plate haptics. Additionally, to evaluate the possible influence of different tamponades on postoperative rotational stability.

A retrospective case-series conducted at Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.

40 eyes of 40 consecutive patients underwent combined 23-gauge phacovitrectomy with implantation of a plate-haptic toric intraocular lens (Zeiss AT TORBI). The main study outcomes were rotational stability and refractive astigmatism up to 12 months postoperatively. The secondary outcome was the best corrected visual acuity (BCVA).

Of overall 40 eyes included 23 eyes received a gas tamponade (C2F6), 16 eyes had air tamponade and one eye received silicone oil. Preoperative refractive astigmatism was -1.99 D ± 1.19 which was subsequently reduced to -0.7 D ± 0.29 postoperatively. Preoperative BCVA was 0.34 ± 0.28 logMAR significantly improving to 0.16 ± 0.12 logMAR postoperatively. Mean IOL axis rotation was 3.3° ± 2.1 within the 12-month observation period. The mean degree of misalignment slightly decreased with time. With respect to tamponade, misalignment in total under air was shown to be 3.14° and under gas 2.32°. Final results of this ongoing study will be presented at the ESCRS congress 2022

In the present case-series we observed the rotational stability and refractive astigmatism of toric IOL after combined phacovitrectomy to be comparable to previous studies. Our data support the notion that misalignment is more likely to occur within the early postoperative phase.