ESCRS - FP20.05 -  Clinical Evaluation And Comparision Of Toric Iol Rotational Stablilty When Implanted Under Balanced Salt Solution (Bss) Vs Ophthalmic Viscosurgical Devices (Ovd)


 Clinical Evaluation And Comparision Of Toric Iol Rotational Stablilty When Implanted Under Balanced Salt Solution (Bss) Vs Ophthalmic Viscosurgical Devices (Ovd)


Published 2023 - 41st Congress of the ESCRS

Reference: FP20.05 | Type: Free paper | DOI: 10.82333/3dpz-0x35

Authors: ROHAN Male BOWRY* 1 , SHEETAL BRAR 2 , SRI GANESH 2

1CATARACT AND REFRACTIVE,INNOCENT HEARTS EYE CENTRE,JALANDHAR,India, 2CATARACT AND REFRACTIVE,NETHRADHAMA SUPER SPECIALITY EYE HOSPITAL,BENGALURU,India

Purpose

To Evaluate and compare Toric IOL Rotational Stablilty when implanted under Balanced salt solution (BSS- Group A) vs Ophthalmic viscosurgical devices (OVD- Group B)

Setting

  • OVERALL STUDY DESIGN: Prospective, interventional clinical trial 
  • NUMBER OF SUBJECTS: 100 eyes of 100 patients(50 in each group)
  • NUMBER OF GROUPS:     2(50 in each group)
  • STUDY DURATION: 12 months
  • SURGICAL PROCEDURE: Standard Phacoemulsification cataract surgery with in the bag implantation of Toric IOL under BSS( GROUP A)/OVD( GROUP B ) aiming at emmetropia in both eyes.

Methods

  • Total of 100 eyes of 100 patients satisfying the inclusion criteria were included in the study. Standard Phacoemulsification was performed with in the bag implantation of the Toric IOL.
  • Pre-op Characteristics such as UDVA, CDVA, keratometry readings (K1 &K2), axial length, corneal astigmatism, IOL power and IOL axis were noted. Biometery was performed using the Barrett’s TK toric formula implemented in the IOL Master 700.
  • A foldable acrylic IOL with acrylic modified C- haptics was used. 
  • The recommended A-constant was used. 
  • All eyes were targeted at emmetropia.
  • Surgeries were performed by a single surgeon. Intraoperatively, surgeon used a markerless system (Callisto eye -Carl Zeiss Meditech) for toric IOL placement along the intended axis.

Results

  • The pre- op characteristics in both the groups were matched .
  • The IOL rotation post opeartively checked with dilated examination and by iTrace( from tracey technologies).
  • In group A (BSS) 80% had rotation within 0-5 degrees, Group B had a rotaion of 5-10 degrees in 30 % patients and > 10 degrees in 8% patients.
  • Group A ( BSS) showed IOL Rotation of 

    3.58 ± 2.56 and Group B (OVD) showed 

    5.02±3.31rotation, which was significant ( p value < 0.01)

     

     

Conclusions

  • A significant increase in Toric Iol rotation in OVD group does makes implantation under BSS safer and more stable.
  • Incomplete removal of OVD in group B can be a factor for Toric IOL rotation.
  • Incomplete OVD clearance, which causes reduced friction between the haptics and the capsular bag.
  • Longer follow up is required, which will look up into the late capsular shrinkage, which might lead to IOL rotation.
  • And also comparison between different brands of toric IOL has to be done in respective BSS and OVD , to check upon the material and design factor , which also might be a factor for topic IOL rotation.