EyeWorld India September 2018 Issue

Head-to-head comparison of toric IOLs One toric lens found to rotate more than the other S table alignment of toric IOLs is critical for achieving a desired refractive outcome. Just 1 degree of misalignment results in about 3.5% loss of cylindrical cor- rection, 2 degrees up to about 7%, and 10 degrees more than 34%. 1 Even if the surgeon aligned the IOL on the proper axis, postopera- tive rotation can and does occur, impacting refractive results. In a study published in Ophthalmology , David F. Chang, MD, clinical professor of ophthalmology, Uni- versity of California, San Francisco, and Altos Eye Physicians, Los Altos, California, and Bryan S. Lee, MD, JD, in private practice with Dr. Chang at Altos Eye Physicians, Los Altos, sought to compare the postoperative rotational stability of the two most commonly im- planted toric monofocal IOLs. 2 “Toric IOLs are the most com- mon premium IOL in our prac- tice,” Dr. Lee said. “We integrated intraoperative aberrometry, then a digital marking system to increase the accuracy of our toric IOL placement, so it was natural for us to study the next step—whether the IOL stays where we put it.” Dr. Lee and Dr. Chang com- pared the axis alignment of the Tecnis toric monofocal IOL (John- son & Johnson Vision, Santa Ana, California) and the AcrySof toric monofocal (Alcon, Fort Worth, Texas) at the first postoperative visit (either day 0 or day 1). The lenses were implanted at a single ambulatory surgery center by the two surgeons using intraopera- tive wavefront aberrometry (ORA VerifEye+, Alcon) and the Callisto Eye digital marking system (Carl Zeiss Meditec, Jena, Germany). Dr. Chang said he and Dr. Lee were not aware of any head-to-head studies evaluating postoperative rotational stability—an impor- tant factor in overall toric IOL performance—between these two platforms. Six hundred and forty-seven Tecnis lenses and 626 AcrySof lenses were implanted during the 18-month study period. Overall, the AcrySof lens showed statisti- cally better rotational stability when compared to the Tecnis lens. More specifically, the AcrySof lens rotated <5 degrees in 91.9% of eyes, compared to 81.8% with the Tecnis lens (p<0.0001), and <10 degrees in 97.8% of eyes compared to 93.2% with the Tecnis (p=0.0002). The net mean rotation of the AcrySof lens was 2.72 degrees, compared to 3.79 degrees with the Tecnis (p<0.05). Though it did not quite reach statistical significance (p=0.1), more patients with the Tecnis lens underwent IOL reposi- tioning compared to the AcrySof (3.1% vs. 1.6%). Though Tecnis lenses were more likely to rotate by the first postop visit, the net mean refrac- tive outcomes between the two groups were similar. “Although the groups were similar demographically, the AcrySof group had significantly by Liz Hillman EyeWorld Senior Staff Writer continued on page 34 EWAP CATARACT/IOL 33 September 2018 The Measure of All Things TrueVision The perfect link to your Leica Microscope N E W Pentacam ® AXL Tomographer and Biometer in One Device OCULUS Asia Ltd. Hong Kong Tel. +852 2987 1050 www.oculus.de • info@oculus.hk In the Pentacam ® AXL our tried and true Pentacam ® technology has become yet another bit better. Its combination of axis length measurement with anterior segment tomography requires a single measurement process to generate all the data needed for presurgical screening and IOL selection and calculation. Thanks to the TrueVision interface you can now also transmit Pentacam ® data directly to your Leica microscope, saving you time, space and money as well as minimizing error sources.