Real-World Comparison Of Rotational Stability And Refractive Outcomes Between Two Toric Intraocular Lenses

To compare rotational stability and its influence on postoperative refraction and visual acuity of two Toric intraocular lenses (IOLs).

Department of Ophthalmology, Shamir Medical Center, Be’er Ya’akov, Israel.

This retrospective cohort study included 180 eyes with preoperative corneal astigmatism who underwent cataract surgery with the enVista MX60T Toric IOL (n = 53) or the Vivinex XY1A-SP Toric IOL (n = 127) implantation. Analyzed outcomes were the amount of IOL misalignment, uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), and manifest refraction at two consecutive postoperative visits:  t₁ (POD 7-14) and t₂ (POD 30-60). 

There were no significant differences in rotational stability between the enVista and Vivinex IOLs at any postoperative time. The mean absolute rotation at t₂ was 2.26 ± 3.22° for enVista and 2.63 ± 4.12° for Vivinex (p = 0.80). Both IOLs demonstrated excellent alignment, with >88% of lenses within 5° and >97% within 10° of the intended axis. Both groups' BCDVA was similar, with mean values of 0.13 logMAR (~20/25 Snellen). However, more Vivinex eyes achieved postoperative manifest cylinder ≤0.75 D (86.5% vs. 70.5%, p=0.021), and 88.5% reached spherical equivalent (SEQ) within ±0.50 D compared to 72.7% of enVista eyes (p=0.018). Vivinex IOLs also demonstrated superior SEQ prediction error (88% vs. 70% within ±0.50 D, p=0.012).

Both Toric IOLs showed excellent rotational stability, while the Vivinex Toric IOL demonstrated favorable results compared to the enVista Toric IOL regarding postoperative refraction.