Rotational Stability And Refractive Outcomes Of A Hydrophilic Acrylic Enhanced Monofocal Toric Intraocular Lens

To assess rotational stability and refractive outcomes of a hydrophilic acrylic enhanced monofocal toric intraocular lens (TIOL) 

This single-center, prospective clinical trial was conducted at the Department of Ophthalmology, Medical University of Vienna.

Sixty-eight patients with cataract and a total corneal astigmatism of more than one diopter measured by AS-OCT (MS39,CSO, Firenze, Italy) were included in this study. Patients received a hydrophilic acrylic enhanced monofocal toric RayOne EMV (Rayner, Worthing, UK) IOL either in one eye or in both eyes. Baseline measurement was performed at the end of surgery (EOS) with the patient still supine on the operating table using non-movable landmarks. Postoperative retroillumination pictures were taken at 1 hour (1h), 1 week (1w), 1 month (1m) and 4- 6 months (6m). Subjective manifest refraction was assessed at the 6m follow up visit. Data is presented as mean± SD [min;max].

Mean absolute rotation from EOS to 6m was 2.14 ± 1.94 [0.08;7.86] degrees. Rotational stability values from EOS to 1h, 1h to 1w, 1w to 1m and 1m to 6m were 0.81 ± 0.77 [0.0;4.11], 0.56 ± 0.47 [0.00;2.76], 1.05 ± 1.16 [0.02;5.23] and 1.13 ± 1.49 [0.0;7.96] degrees. The respective rates of TIOLs rotating more than 3 degrees within the time span of EOS to 1h, 1h to 1w, 1w to 1m and 1m to 6m were 1.4%, 0%, 8.8% and 8.8%. Overall 7 TIOLs (10.2%) rotated more than 5 degrees and 0 TIOLs rotated more than 10 degrees. Mean absolute preoperative corneal astigmatism was 1.69 ± 0.64D. Mean absolute postoperative refractive astigmatism was 0.30 ± 0.27D at 6m. No repositioning surgery had to be performed. 

The RayOne EMV TIOL demonstrated very good rotational stability during both the initial hour and the first week post-implantation. Notably, as capsular fibrosis and capsular shrinkage began to develop, the TIOL exhibited progressive rotation after the first week. This finding contrasts with our previous studies, where most IOL rotation was observed within the first hour after implantation.