Toric Intraocular Lens Research Articles

Comparative Analysis of the Clinical Outcomes of Two Toric Presbyopia-Correcting Intraocular Lenses.

To evaluate and compare the clinical outcomes of two toric presbyopia-correcting intraocular lenses (IOLs). Non-randomized prospective comparative study including 86 eyes of 51 patients (age 43-83years) that underwent cataract surgery with implantation of one of the following two IOLs: TECNIS Toric Synergy (Johnson & Johnson Vision) (Synergy group) or AT LISA tri toric 939MP (Carl Zeiss Meditec) (ATLISA group). Visual and refractive outcomes were evaluated during a 6-month follow-up. At 6months after surgery, all eyes achieved uncorrected distance visual acuity 20/25 or better in both groups, whereas 96.2% and 100% of eyes achieved uncorrected near visual acuity (UNVA) 20/25 or better in the ATLISA and Synergy groups, respectively. All eyes achieved postoperative mesopic UNVA 20/30 or better in both IOL groups; 96.2% and 100% of eyes had a manifest cylinder ≤ 0.50 D at 6months in ATLISA and Synergy groups, respectively. Mean magnitude of error was 0.04 ± 0.20 and - 0.04 ± 0.09 D in ATLISA and Synergy groups, respectively (p = 0.05). In the defocus curve, significant differences were found between IOL groups for most of distance-corrected visual acuities, except those corresponding to defocus of 0 D (p = 0.268) and - 1 D (p = 0.361). The two toric presbyopia-correcting IOLs evaluated provide an efficacious astigmatic correction combined with a successful distance, intermediate and near visual rehabilitation. The visual performance seems to be better for most visual demands with the TECNIS Toric Synergy IOL, especially for distances closer than 40cm.

A clinical case of a combined method for correcting postkeratoplastic astigmatism of a high degree in a patient with cataract

Background. Performing penetrating keratoplasty in 100 % of cases leads to the occurrence of induced postkeratoplasty astigmatism, which can be more than 12,0 D. If cataracts occur in this category of patients, performing cataract phacoemulsification with implantation of a toric intraocular lens (tIOL) does not completely solve the problem. The use of the method of implantation of intrastromal corneal segments at stage I before cataract phacoemulsification makes it possible to reduce the degree of postkeratoplasty astigmatism and create optimal conditions for additional correction of residual postkeratoplasty astigmatism due to the implantation of tIOL during cataract phacoemulsification.The aim. To analyze the clinical and functional indicators of correction of regular high-grade postkeratoplasty astigmatism in a patient with cataracts using a combined method, including first implantation of intrastromal corneal segments and subsequent cataract phacoemulsification with implantation of toric intraocular lens using the example of a clinical case.Material and methods. A 55-year-old patient with cataracts, who had a history of undergoing penetrating keratoplasty, contacted us. According to the keratotopogram data, a regular postkeratoplasty astigmatism of 18.68 D was diagnosed. The patient underwent a combined method. At stage I, intrastromal corneal segments were implanted into the corneal graft, then after 6 months stage II was performed – cataract phacoemulsification with implantation of tIOL.Results. Six months after intrastromal corneal segments implantation, the patient’s keratometric data stabilized, and corneal astigmatism decreased to 8.98 D. Then the patient underwent cataract phacoemulsification with tIOL implantation. After 1 month, the spherical component of refraction was 0.5 D, the cylindrical component of refraction was –0.5 D, visual acuity increased to 1.0.Conclusions. A combined method for correcting regular high-grade postkeratoplasty astigmatism in a patient with cataracts showed high refractive results, stability and safety in the long-term postoperative period.

Total keratometry for toric intraocular lens calculation: comparison from two swept-source optical coherence tomography biometers.

To compare the astigmatism prediction accuracy of total keratometry (TK) from the IOLMaster 700 and total corneal power (TCP) from Anterion based on swept-source optical coherence tomography (SS-OCT) technology in toric intraocular lens (toric IOL) calculation. A retrospective observational study. Total corneal astigmatism (TCA) were obtained using IOLMaster 700 and Anterion. Z CALC 2.0 was used to calculate the expected postoperative refractive astigmatism in conjunction with TCA. Prediction errors (PE) in refractive outcomes was analyzed 1 month postoperatively using the vector analysis by the Holladay method, including the mean vector PE magnitude, percentage of cases with vector PE in certain intervals, and the centroid PE. A total of 56 eyes from 56 patients were enrolled in the study with an insertion of an AT TORBI 709 toric IOL. The difference in mean vector PE of postoperative refractive astigmatism between TK and TCP was not statistically significant (0.48D versus 0.46D, P = 0.281). TK and TCP yielded 27.3 and 40.0% of eyes with vector PE ≤ 0.25D, and 58.2 and 63.6% with vector PE ≤ 0.5D (both P > 0.05), respectively. TK and TCP resulted in similar ATR centroid PE of 0.10D@35° ± 0.60D and 0.15D@22° ± 0.57D, respectively, and there were no significant differences between x-PE component and y-PE component. IOLMaster 700 and Anterion provided comparable astigmatic predictability in toric IOL implantation using total keratometry and Z CALC 2.0.

Hydrophobic Trifocal Toric Intraocular Lens Outcomes in Japanese Eyes After Cataract Surgery.

To analyze the refractive and visual outcomes following cataract surgery and implantation of a new hydrophobic trifocal toric intraocular lens (IOL) in Japanese eyes with different degrees of corneal astigmatism. A total of 66 eyes from 39 patients implanted with a FineVision HP Toric IOL (Beaver-Visitec International Inc) were analyzed retrospectively. The main outcome measures considered were refraction, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Eyes were evaluated at three months post-surgery. Sixty-five eyes (98.48%) were within ±0.50D of spherical equivalent, and all were within ±1.00D (mean: 0.00±0.21D). Moreover, 63 eyes (95.45%) had ≤0.50D of residual astigmatism, and all had ≤1.00D (mean: -0.08±0.23D). Similarly, 58 (87.88%) and 60 eyes (90.91%) had ≥20/20 UDVA and CDVA, respectively, with 65 (98.48%) and 66 eyes (100%) achieving ≥20/25 UDVA and CDVA, respectively. In addition, 28 (42.42%) and 23 eyes (34.85%) had ≥20/25 DCIVA at 80 and 66 cm, respectively, with 49 (74.24%) and 52 eyes (78.79%) achieving ≥20/32 DCIVA at 80 and 66 cm, respectively. Finally, 39 (59.09%) and 40 eyes (60.61%) had ≥20/20 UNVA and DCNVA, respectively, with 58 (87.88%) and 59 eyes (89.39%) achieving ≥20/25 UNVA and DCNVA, respectively. Our study shows that implantation of the new hydrophobic FineVision HP Toric IOL results in accurate refractive outcomes, with good visual acuity at different distances, in Japanese eyes.

The Application of Femtosecond Laser–Assisted Astigmatic Keratotomy on the Correction of Asymmetric Astigmatism: A Case Series

Purpose: To present the use of femtosecond laser–assisted astigmatic keratotomy (FSAK) with or without a toric intraocular lens (IOL) for the correction of asymmetric astigmatism. Methods: Case series and review of the literature. Results: Cases 1 and 2 showed low-grade but asymmetric astigmatism on the corneal topography. After FSAK management, which made two corneal incisions in both patients, case 1 revealed prominently reduced corneal astigmatism and manifest refraction and the astigmatic axis of case 2 became more direct. Cases 3 to 5 demonstrated higher degrees of asymmetric astigmatism and FSAK was performed with toric IOL implantation in patients with asymmetric astigmatism, creating an incision at the corneal surface with a higher amount of astigmatism. Postoperatively, the corneal astigmatism displayed considerable decrement in cases 3 to 5. No optical symptoms were reported in any cases. Conclusions: FSAK is a safe and effective method for correcting moderate asymmetric astigmatism and can be combined with toric IOL implantation. [ Journal of Refractive Surgery Case Reports. 2024;4(1):e15–e19.]

Evaluation of rotational stability of two toric intraocular lenses, Acrysof IQ Toric and Tecnis Toric, using new ToriCalc software

Evaluation of rotational stability of two toric intraocular lenses, Acrysof IQ Toric and Tecnis Toric, using new ToriCalc software

Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power.

To investigate toric monofocal intraocular lens (TIOL) rotation and associated changes in cylinder power caused by Nd:YAG laser capsulotomy performed due to posterior capsule opacification (PCO). Ekol Eye Hospital, Izmir, Turkey. Prospective case series. 41 eyes of 20 women and 21 men were included in the study. Before and 1 month after Nd:YAG laser capsulotomy, TIOL tilt and decentration were determined with Scheimpflug camera, and TIOL axial rotation and the change in cylinder power induced by this rotation were measured by ray tracing aberrometry. The time interval between cataract surgery and Nd:YAG laser capsulotomy was noted. Rotational misalignment of the TIOL was measured as 4.65 ± 2.75 degrees (range 0 to 11 degrees) before vs 6.97 ± 2.92 degrees (range 0 to 13 degrees) after capsulotomy, and absolute rotation was 2.75 ± 1.94 degrees (range 0 to 7 degrees, P = .028). Before and after Nd:YAG laser capsulotomy, cylinder power was 0.24 ± 0.70 diopter (D) (range 0.00 to 0.63 D) vs 0.56 ± 0.77 D (range 0.02 to 0.91 D), respectively, with an absolute change in cylinder power of 0.34 ± 0.22 D (range 0.01 to 0.90 D, P = .001). After capsulotomy, there was a significant decrease in IOL tilt in the horizontal and vertical planes and an increase in decentration ( P < .05). Time interval (33.02 ± 12.9 months) and IOL horizontal decentration were independent factors affecting IOL rotation after capsulotomy ( P < .05). Nd:YAG laser capsulotomy may cause TIOL rotation as well as tilt and decentration, resulting in a change in the TIOL's corrective effect on corneal astigmatism. Although this change was clinically insignificant, it may be beneficial to consider that TIOL rotational misalignment may occur in patients undergoing early capsulotomy.

Visual Function After Implantation of Trifocal and Trifocal Toric Intraocular Lenses Using Intraoperative Aberrometry.

To evaluate patient outcomes and visual function following trifocal and trifocal toric intraocular lens (IOL) implantation using intraoperative aberrometry at a single site in the US. This prospective, single arm study included 21 subjects that completed 3 month follow-up. Inclusion criteria were visually significant cataract and potential post-operative visual acuity of 20/25 or better. Endpoints included postoperative prediction error, refractive outcomes, uncorrected visual acuities at distance (UDVA), intermediate (UIVA), and near (UNVA), contrast sensitivity, and subject responses on the modified Visual Function Quality of Life Questionnaire (VF-14 QOL). Binocular UDVA, UIVA, and UNVA were 20/25 or better in 100% (21/21), 100% (21/21), 90% (19/21) of subjects. The absolute prediction error was 0.50 D or less in 79% (33/42) of eyes, and 81% (34/42) and 86% (36/42) of eyes achieved ≤0.5 D of residual astigmatism and manifest refraction spherical equivalent, respectively. On the modified VF-14 QOL, driving at night, reading small print, and reading a newspaper or book were the tasks that had the lowest percentages of subjects reporting no difficulty or a little difficulty. Implantation with trifocal and trifocal toric IOLs using intraoperative aberrometry can provide high refractive precision, leading to excellent visual performance and low visual task difficulty at all ranges (distance, intermediate, and near).

Outcomes After Implantation of a Trifocal Toric Intraocular Lens Using Intraoperative Aberrometry, Digital Image Tracking, and Femtosecond Laser.

To evaluate the refractive and visual acuity outcomes when using trifocal toric intraocular lenses (IOLs), femtosecond laser assisted cataract surgery (FLACS), swept-source optical coherence tomography (SS-OCT) biometry, digital image tracking (DT) and intraoperative aberrometry (IA). This prospective, single-arm, observational study of refractive and visual outcomes included 40 eyes of 34 subjects. Preoperative biometry was performed with the Argos, FLACS and digital marking with LenSx, and IA and DT with ORA. Eyes were implanted with the Clareon PanOptix toric IOL. Study outcome measures included absolute prediction error, residual refractive astigmatism, and monocular uncorrected and distance corrected visual acuity at distance (UDVA, CDVA), intermediate (UIVA, DCIVA; 60cm), and near (UNVA, DCNVA; 40cm). Mean absolute prediction error (spherical equivalent) was 0.43 ± 0.36 D, and the percentage of eyes with absolute prediction error ≤ 0.5 D was 72.5% (29/40 eyes). Mean residual astigmatism was 0.36 ± 0.65 D, and the percentage of eyes with residual astigmatism ≤ 0.5 D was 80% (32/40 eyes). Monocular UDVA, UIVA, and UNVA was 20/25 or better in 75%, 64%, and 87% of eyes respectively. Monocular CDVA, DCIVA, and DCNVA was 20/25 or better in 95%, 64%, and 87% of eyes respectively. The results of this study suggest that trifocal toric implantation with SS-OCT, FLACS, DT, and IA can provide excellent refractive and visual outcomes.

Clinical Performance of an Omnidirectional Aberration-Free Trifocal Toric Intraocular Lens.

To assess the refractive and visual outcomes at different distances following cataract surgery with implantation of an omnidirectional aberration-free diffractive trifocal toric intraocular lens (IOL). A total of 24 patients who underwent bilateral implantation with the TrivaT-aAY IOL were analyzed at 3-4 months post-surgery. Refractive error, monocular and binocular uncorrected and corrected-distance visual acuity (UDVA, CDVA), uncorrected and corrected-distance intermediate visual acuity (UIVA, CDIVA) at 60 cm, uncorrected and corrected-distance near visual acuity (UNVA, CDNVA) at 40 cm, monocular and binocular defocus curve and rotational stability were measured. Patients also completed the Catquest-9SF questionnaire at the last postoperative visit. The postoperative mean values of binocular logMAR CDVA, CDIVA and CDNVA were -0.06±0.06, 0.05±0.07 and 0.07±0.08, respectively. One hundred percent of patients showed a cumulative binocular CDVA ≥20/25, and 95.83% of patients showed a cumulative binocular CDIVA and CDNVA ≥20/32. The mean postoperative spherical equivalent was 0.07±0.26D and 100% and 97.92% eyes were within ±1.00D and ±0.50D, respectively. The mean postoperative refractive cylinder was -0.22±0.29D and 100% and 89.58% eyes showed a value ≤1.00D and ≤0.50D, respectively. The defocus curves showed a wide range of useful vision, with visual acuity values >0.2 logMAR. Mean absolute IOL rotation was 2.19±2.17 degrees and all eyes had a rotation <10 degrees. For the questionnaire, 95.83% of patients reported being quite satisfied to very satisfied with their vision and about 79.17% did not report any difficulty with their vision in their everyday life. Between 83.33% and 95.83% of patients reported no difficulty performing different tasks. No intra- and postoperative complications were reported during the follow-up. Our study shows that the TrivaT-aAY IOL provides good visual acuities at all distances and refractive outcomes with excellent rotational stability and with high satisfaction among our patients after its implantation.

Astygmatyzm w kontekście operacji usunięcia zaćmy z wykorzystaniem torycznych soczewek wewnątrzgałkowych – aktualny przegląd piśmiennictwa

Assessment and management of astigmatism is often difficult, and one of the specific situations in which this problem must be faced is when a patient with astigmatism is qualified for cataract surgery. A relatively predictable method of astigmatism correction during a single procedure and also the method of choice in the treatment of cataracts accompanied by corneal astigmatism is cataract phacoemulsification with implantation of toric intraocular lenses. The aim of the study is to review the current literature on this topic. The prevalence of corneal astigmatism ≥1.0 D in patients with cataract varies in various studies from 34.8 to 66.9%, which illustrates the scale of demand for this procedure. The paper discusses the key aspects of pre-operative assessment of astigmatism, including the changes that occur with the aging process. The importance of measuring the posterior corneal astigmatism and the consequences of its neglect in the form of deviations in the assessment of total corneal astigmatism and postoperative residual refractive errors were emphasized. Attention was paid to available updates of toric calculators and innovations in cases of irregular astigmatism.

Wybrane zagadnienia dotyczące implantów torycznych wszczepianych podczas operacji usunięcia zaćmy i operacji refrakcyjnej wymiany soczewki

Toric intraocular lens implantation is currently a preferred method of astigmatism correction in patients with cataract and during refractive lens exchange. Astigmatism-correcting lenses enable significant visual acuity improvement and increase patient satisfaction after the surgery. In order to achieve optimal postoperative results, it is required to conduct proper qualification, thorough and reliable keratometry measurements before surgery as well as consider potential contraindications to toric intraocular lens implantation. The aim of this review is to outline current indications and contraindications for toric lens implantation and to introduce toric lens power calculation methods

Toric Monofocal Intraocular Lenses for the Correction of Astigmatism during Cataract Surgery: A Report by the American Academy of Ophthalmology

To review the published literature evaluating the visual and refractive outcomes and rotational stability of eyes implanted with toric monofocal intraocular lenses (IOLs) for the correction of keratometric astigmatism during cataract surgery and to compare those outcomes with outcomes of eyes implanted with nontoric monofocal IOLs and other astigmatism management methods performed during cataract surgery. This assessment was restricted to the toric IOLs available in the United States. A literature search of English-language publications in the PubMed database was last conducted in July 2022. The search identified 906 potentially relevant citations, and after review of the abstracts, 63 were selected for full-text review. Twenty-one studies ultimately were determined to be relevant to the assessment criteria and were selected for inclusion. The panel methodologist assigned each a level of evidence rating; 12 studies were rated level I and 9 studies were rated level II. Eyes implanted with toric IOLs showed excellent postoperative uncorrected distance visual acuity (UCDVA), reduction of postoperative refractive astigmatism, and good rotational stability. Uncorrected distance visual acuity was better and postoperative cylinder was lower with toric IOLs, regardless of manufacturer, when compared with nontoric monofocal IOLs. Correcting pre-existing astigmatism with toric IOLs was more effective and predictable than using corneal relaxing incisions (CRIs), especially in the presence of higher magnitudes of astigmatism. Toric monofocal IOLs are effective in neutralizing pre-existing corneal astigmatism at the time of cataract surgery and result in better UCDVA and significant reductions in postoperative refractive astigmatism compared with nontoric monofocal IOLs. Toric IOLs result in better astigmatic correction than CRIs, particularly at high magnitudes of astigmatism. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Scleral Fixation of a Single-Piece AcrySof Toric Intraocular Lens: A Case Report

Purpose: To describe a simple and least invasive surgical method of transscleral fixation of a dislocated single-piece AcrySof® toric intraocular lens (IOL).Case summary: A 62-year-old male was referred with dislocated toric IOL (SN6AT4, AcrySof® IQ Toric; Alcon Laboratories, Fort Worth, TX, USA) in his right eye after an uneventful cataract surgery. Scleral fixation using the toric IOL was performed by placing the suture knot at the optic-haptic junction right beside the toric axis markings which easily achieved the desired positioning of the axis. The preoperative uncorrected distance visual acuity was 20/400 and it improved to 20/60 at 1 week after repositioning of the IOL and the IOL was well-centered with its toric alignment within 5 degrees of the intended axis.Conclusions: Transscleral fixation of single-piece AcrySof toric IOLs is easy to learn technique, which reduces surgical time with minimal manipulation and enables IOL stability with good postoperative toric axis alignment.

Comments on comparison of clinical outcomes of Eyecryl Toric and Alcon Toric intraocular lenses: A real-world study.

Comments on comparison of clinical outcomes of Eyecryl Toric and Alcon Toric intraocular lenses: A real-world study.

Comparison of dynamic visual acuity after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients: a randomized controlled trial.

To investigate the dynamic visual acuity (DVA) after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients. This was a prospective randomized controlled trial. Of one hundred and twenty-four patients enrolled and randomized to receive unilateral phacoemulsification and toric trifocal (939 M/MP, Carl Zeiss Meditec AG, Jena, Germany) or toric bifocal (909 M, Carl Zeiss Meditec AG, Jena, Germany) intraocular lenses (IOL) implantation, ninety-nine patients completed the follow-up and were included in final analysis. Postoperatively, uncorrected and corrected distance (UDVA and CDVA), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) static visual acuity, manifest refraction and uncorrected and corrected distance DVA (UDDVA and CDDVA) at 20, 40 and 80 degrees per second (dps) were evaluated at one week, one month and three months. Three months postoperatively, the UDVA were 0.13 ± 0.11 and 0.14 ± 0.13 in the toric trifocal and bifocal IOL group, respectively. Significant better UIVA (trifocal, 0.17 ± 0.13 vs. bifocal, 0.23 ± 0.13, p = 0.037) and DCIVA (trifocal, 0.16 ± 0.11 vs. bifocal, 0.20 ± 0.12, p = 0.048) were observed in patients implanting toric trifocal than bifocal IOL at three months postoperatively. Patients implanted with toric bifocal IOL obtained better CDDVA at 80 dps (0.5607 ± 0.2032) than the trifocal group (0.6573 ± 0.2450, p = 0.039) at three months. Postoperative UDDVA and CDDVA at 20, 40 and 80 dps were significantly associated with age (p < 0.05, respectively) and postoperative static visual acuity (p < 0.05, respectively). Toric trifocal IOL provides better static intermediate visual acuity, and toric bifocal IOL implantation provides better distance dynamic visual acuity at high speed.

Способ подбора данных кератометрии для расчета торичности ИОЛ

Purpose. To elaborate the customized principle of determining the actual zone of the corneal astigmatism based on keratotopographic data and compare the accuracy of calculating the toric IOL according to the actual zone and conventional keratometry. Material and methods. The study included 48 patients (48 eyes) who underwent toric IOL implantation. 3–6 months (5.1±0.6) after surgery, all patients were measured the residual refractive astigmatism. The toric IOL was retrospectively calculated according to the data of the actual keratotopographic zone determined by the proposed method (1st group) and according to conventional keratometry (2nd group). Vector and centroid analyses were used to estimate the error in calculating the IOL toricity. Results. The principles of determining the actual zone are based on the assumption that maximum visual acuity and visual quality can be achieved when the regularity of astigmatism in the central parts of the cornea corresponds to the regularity of toric IOL. The mean diameter of the selected actual zone was 2.93±0.61 (from 2.0 to 4.3 mm respectively). The average vector error of toricity calculation in 1st group was 0.30±0.31, in 2nd group – 0.42±0.30 (p=0.006). Centroid analysis showed similar values of centroid error in 1st group and 2nd group (0.09 and 0.08), while the dispersion was higher in 2nd group (0.42 and 0.51, respectively). Conclusion. The customized principle of selecting the actual zone according to topographic maps of the cornea showed a more accurate calculation of the IOL toricity compared with the use of conventional keratometry data. Key words: toric IOL, corneal astigmatism, IOL calculation accuracy, keratometry, keratotopography

Repositioning Rates of Toric IOLs Implanted in Cataract Surgery Patients: A Retrospective Chart Review.

To determine the incidence of postoperative repositioning of toric intraocular lenses (IOLs) due to clinically significant rotation. This study included consecutive cataract patients with pre-existing astigmatism who had undergone cataract surgery with toric IOL implantation by a single experienced surgeon. Case records of patients who were recommended to undergo toric IOL repositioning surgery due to clinically significant postoperative IOL rotation from the implanted axis were identified. The need for a secondary intervention to manage residual astigmatism was based upon postoperative residual astigmatic error ≥0.75 D, the patient's qualitative dissatisfaction with the level of postoperative distance vision, dilated post-op examination, and confirmation of the significant potential for astigmatism reduction. Case records of 993 eyes implanted with AcrySof toric (N = 362), Tecnis Toric I (N = 53), Tecnis Toric II (N = 308), or enVista Toric IOLs (N = 270) were included. Postoperative toric IOL repositioning was recommended in 16 eyes (1.6%). The repositioning rate was highest in the eyes implanted with Tecnis Toric I (5.7%), followed by AcrySof Toric (2.2%), enVista Toric IOLs (1.1%), and Tecnis Toric II (0.6%). This real-world analysis of eyes implanted with toric IOLs revealed that the rate of surgical IOL repositioning due to clinically significant IOL rotation was lower than 2% for enVista and Tecnis Toric II IOLs. When needed and with appropriate planning, toric IOL repositioning can be very successful.

Comparison of two objective methods for measuring postoperative toric intraocular lens orientation under the natural pupil.

To evaluate and compare the accuracy of iTrace and CASIA2 in measuring the postoperative orientation of toric intraocular lens (IOL) without mydriasis. Tianjin Medical University Eye Hospital, Tianjin, China. Prospective cohort study. Patients with SN6AT toric IOLs implanted after cataract surgery were enrolled. 1 month after surgery, the toric IOL orientation were measured by iTrace and CASIA2 in non-mydriatic, semi-dark conditions. Then, the toric axis was directly reviewed using the slit-lamp under full mydriasis. Axis measurement differences between each of the 2 devices and the slit-lamp, described as their relative differences (RDs), were calculated and compared. The percentage of RDs within 5 degrees, within 10 degrees and greater than 30 degrees were analyzed. 77 eyes of 70 patients were included. Generally, the mean toric axis measurement RDs of CASIA2 and iTrace were 9.24 ± 10.53 degrees and 13.89 ± 15.47 degrees respectively ( P = .04). For CASIA2 (72 eyes), 54.17% (39), 72.22% (52), and 4.17% (3) of eyes had RDs within 5 degrees, within 10 degrees and greater than 30 degrees, compared with 40.00% (28), 61.43% (43) and 12.86% (9) for iTrace (70 eyes). The 95% limits of agreements of CASIA2 with slit-lamp was narrower than that of iTrace with slit-lamp. The median RD of CASIA2 was significantly smaller in eyes with pupil ≥4 mm under dark condition compared with eyes with pupil <4 mm ( P = .03). CASIA2 demonstrates greater precision in measuring toric IOL orientation under non-mydriatic conditions compared with iTrace. Moreover, the accuracy of CASIA2 is enhanced in cases of pupil >4 mm.

Head-to-Head Comparison of Intermediate Vision of Two Monofocal Intraocular Lenses.

To compare intermediate visual outcomes in patients previously implanted with bilateral Clareon monofocal IOLs versus bilateral Eyhance IOLs. This was a non-interventional, single-center, examiner-masked, comparative study. Participants were cataract patients presenting at least 3 months after uncomplicated, bilateral implantation of either Clareon or Eyhance non-toric and toric IOLs. Outcomes measures included binocular distance-corrected intermediate visual acuity (DCIVA), binocular corrected distance visual acuity (CDVA), binocular best-corrected defocus curve, postoperative mean residual spherical equivalent (MRSE), and residual astigmatism. A total of 620 eyes of 310 subjects (155 subjects per group) were evaluated. The mean difference in DCIVA was 0.05 logMAR between the Eyhance and Clareon IOLs which was significant (p < 0.01), but within the 0.1 logMAR non-inferiority margin. Mean CDVA of the Clareon group was 0.01 ± 0.03 logMAR compared to 0.02 ± 0.03 logMAR of the Eyhance Group (p > 0.05). Defocus curves from +1.0 D to -3.0 D were not clinically nor statistically different between the Clareon and Eyhance groups (p > 0.05). The results of this study show that bilateral implantation of Clareon monofocal IOLs and Eyhance monofocal IOLs lead to similar distance and intermediate visual outcomes.