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Assessing postoperative toric intraocular lens rotation: comparative analysis.

Marcus Lisy1, Victor Danzinger, Markus Schranz

  • 1From the Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

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|November 27, 2024
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Summary

Accurately measuring toric intraocular lens (TIOL) rotation requires using fixed anatomical landmarks and establishing an end-of-surgery baseline. Considering eye cyclorotation is crucial when assessing TIOL rotation along the horizontal axis.

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Optical Coherence Tomography

Background:

  • Toric intraocular lenses (TIOLs) are used to correct astigmatism during cataract surgery.
  • Accurate rotational stability of TIOLs is critical for achieving desired visual outcomes.
  • Standardized methods for measuring TIOL rotation are essential for clinical evaluation.

Purpose of the Study:

  • To compare the accuracy of three distinct methods for measuring postoperative toric intraocular lens (TIOL) rotational stability.
  • To evaluate the reliability and agreement between different TIOL rotational measurement techniques.

Main Methods:

  • A prospective, interventional study involving 128 eyes of 81 patients undergoing cataract surgery with a specific TIOL (Clareon CNW0T3-9).
  • Three methods were employed: Rotix (scleral vessel reference), Slitlamp (horizontal axis reference), and Casia (swept-source OCT axis determination tool).
  • Measurements were taken at the end of surgery (EoS), 1 week, and 6 months postoperatively to assess TIOL axis stability.

Main Results:

  • Significant differences in mean absolute rotation were observed between Rotix (1.33°), Casia (2.88°), and Slit-lamp (4.38°) at 6 months (P < .001).
  • Bland-Altman coefficients of repeatability (CoRs) showed the closest agreement between Casia and Rotix (±3.95°), followed by Slit-lamp/Casia (±6.82°) and Slit-lamp/Rotix (±7.19°).

Conclusions:

  • For accurate TIOL rotational stability assessment, utilizing fixed anatomical landmarks and establishing an end-of-surgery baseline is imperative.
  • When measuring TIOL rotation along the horizontal axis, accounting for ocular cyclorotation is crucial and should not be underestimated.