Posters

Comparative rotational stability of toric intraocular lenses: a systematic literature review and meta-analysis

Poster Details

First Author: A.Dmitriew POLAND

Co Author(s):    D. O’Boyle   C. Perez Vives   L. Saini   P. Cooney           

Abstract Details

Purpose:

Astigmatism is a refractive error typically resulting from anterior corneal asymmetry. Preoperative astigmatism ≥0.5 diopters is present in up to 77% of cataract eyes. Toric IOLs (TIOLs) are a safe and effective means of treating astigmatism. However, an issue sometimes experienced with TIOLs is postoperative rotational stability, which can impair astigmatic correction. Indeed, even small deviations in rotation of TIOLs from their intended axis can result in reducing astigmatic correction (3% power reduction per degree of rotation). The purpose of this research was to assess the literature with respect to rotational stability outcomes and compare across different types of TIOLs.

Setting:

A systematic literature search was conducted on Embase®, MEDLINE®, MEDLINE®-In Process, and Cochrane databases to include studies from January 1974 through July 2019.

Methods:

We performed a systematic literature search in the Embase®, MEDLINE®, MEDLINE®- In Process, and Cochrane databases from January 1974 through July 2019. We included randomized clinical trials (RCTs) and non-RCTs if they included rotational stability outcomes for Alcon AcrySof TIOLs and other TIOLs, in patients with regular corneal astigmatism and age-related cataracts. A direct meta-analysis of overall mean absolute rotation was conducted using a random effects model, with AcrySof TIOLs in one arm and the other available TIOLs grouped together in the other arm.

Results:

Three RCTs and three non-RCTS met the inclusion criteria and were assessed. All six studies included the AcrySof TIOL and Staar TIOL: 1 study; Tecnis TIOL: 4 studies; POD FT: 1 study, AT Torbi: 1 study. Reported absolute mean rotation, at 1 month post-operatively, varied from 2.05±2.56°–4.64±4.50° for AcrySof TIOLs and 3.48±3.86°–9.45±7.0° for other TIOLs. At three months post-operatively, reported rotations were ≤ 5° in 73%-95.2% for AcrySof TIOLs and 37%-76.19% for other TIOLs. AcrySof TIOLs were associated with significantly better postoperative rotational stability compared to the group of other TIOLs (weighted mean difference: -0.94 CI: - 1.6, -0.28).

Conclusions:

AcrySof TIOLs are associated with excellent postoperative rotational stability and as demonstrated in this research, are likely to rotate less postoperatively, compared with a group of other available TIOLs. Factors that contribute to the performance of AcrySof TIOLs in this respect are their single-piece design and biomaterial composition, which allows for binding with the lens capsule that stabilizes the lens in its desired position.

Financial Disclosure:

is employed by a for-profit company with an interest in the subject of the presentation, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented