Comparative Study Of Rotational Stability And Clinical Outcomes Between Intensity Toric And Eyhance Toric Iols Using A Digital Marker System

To evaluate and compare the rotational stability and visual outcomes of two different toric intraocular lenses (IOLs): the five-haptic continuous range of vision IOL (Intensity Toric, Hanita) and the monofocal IOL with extended depth of focus (Eyhance Toric, Johnson & Johnson).

Yonsei Chang Eye Clinic, Seoul, South Korea.

This retrospective study included 60 eyes of 60 patients undergoing uncomplicated cataract surgery with toric IOL implantation. Thirty eyes received the Intensity Toric IOL and 30 eyes received the Eyhance Toric IOL. All surgeries were performed by a single experienced surgeon using a digital image-guided alignment system (Callisto Eye) to ensure precise axis placement. Preoperative biometry and keratometry were obtained for toric power calculation. The primary outcome was absolute IOL rotation at 3 months, and secondary outcomes included uncorrected distance visual acuity and residual refractive cylinder. Independent t-tests were used for statistical comparisons.

At 3 months postoperatively, the mean absolute IOL rotation was 6.50 ± 1.14° in the Intensity group and 5.80 ± 1.46° in the Eyhance group, showing no statistically significant difference (p=0.42). In both groups, most eyes remained within clinically acceptable rotational limits, and no case required secondary repositioning. Mean uncorrected distance visual acuity was 1.04 ± 0.27 (decimal) in the Intensity group (approximately 20/20 Snellen)and 1.00 ± 0.14(20/20 Snellen) in the Eyhance group (p=0.78), demonstrating comparable visual recovery. The mean residual refractive cylinder was approximately 0.25 D in both groups. No significant IOL tilt, decentration, or vision-threatening complications were observed during follow-up.

Both Intensity Toric and Eyhance Toric IOLs demonstrated excellent rotational stability and highly predictable refractive outcomes at 3 months after cataract surgery. No statistically significant differences were observed in mean IOL rotation, uncorrected distance visual acuity, or residual astigmatism between the two platforms. The five-haptic design of the Intensity Toric lens provided stable capsular fixation comparable to the established Tecnis-based Eyhance system when combined with precise digital intraoperative alignment. These findings indicate that both IOLs are reliable options for astigmatism correction in routine cataract surgery and highlight the critical role of image-guided systems in achieving optimal toric performance.