Reproducibility of the Magnitude of Lens Rotation Following Implantation of a Toric Intraocular Lens with Modified Haptics

Gabriel A Quesada; Rodrigo A Quesada; Jason J Jones; Benjamin J K Straker; Wuchen Zhao; Linda Tsai; Srividhya Vilupuru

doi:10.2147/OPTH.S373976

Reproducibility of the Magnitude of Lens Rotation Following Implantation of a Toric Intraocular Lens with Modified Haptics

Clin Ophthalmol. 2022 Sep 29:16:3213-3224. doi: 10.2147/OPTH.S373976. eCollection 2022.

Authors

Gabriel A Quesada¹, Rodrigo A Quesada¹, Jason J Jones², Benjamin J K Straker³, Wuchen Zhao³, Linda Tsai³, Srividhya Vilupuru³

Affiliations

¹ Centro de Oftalmología y Cirugía Plástica, San Salvador, El Salvador.
² Jones Eye Clinic, Sioux City, IA, USA.
³ Johnson & Johnson Surgical Vision, Inc, Irvine, CA, USA.

Abstract

Purpose: To evaluate the reproducibility of magnitude of postoperative IOL rotation following implantation of a toric intraocular lens (IOL) with modified haptics, in comparison with a Proof-of-Concept (POC) study of prototype IOLs featuring the same haptic design.

Patients and methods: A post-market, prospective, multicenter, single-arm, open-label clinical study was conducted. TECNIS Toric II IOL (Johnson & Johnson Vision, Irvine, CA, USA, Models ZCU150 to 600) were implanted in 125 subjects and evaluated at 1-day and 1-week postoperatively. An objective photographic method was used to determine postoperative IOL rotation. Uncorrected distance visual acuity (UCDVA), postoperative astigmatism, and surgeon satisfaction were also assessed. Rotation data were compared to the POC study in which two prototype non-toric monofocal IOLs, one with the same haptic design as Model ZCU, were studied.

Results: Mean absolute rotation was 0.82° ± 1.0° and 0.84° ± 0.92°at 1-day and 1-week visits, respectively. The percentage of eyes with ≤5° of absolute rotation was 98.9% and 99.5% at the 1-day and 1-week visits, respectively. The magnitude of rotation was similar to the POC study prototype IOLs. At 1-week, mean monocular UCDVA was 0.026 ± 0.135 (~20/21) logMAR and mean residual manifest refractive cylinder was 0.30 D ± 0.35 D. The mean signed axis difference (postoperative minus operative) of the TECNIS Toric II IOL was 0.23° ± 1.27° at 1-day and -0.07° ± 1.25° at 1-week, indicating a clockwise drift. At 1-week, surgeons were very satisfied or satisfied with overall clinical outcomes and rotational stability in 98% of implanted eyes.

Conclusion: The TECNIS Toric II IOL, with frosted, squared haptics, demonstrated low magnitude of postoperative IOL rotation, excellent uncorrected distance vision, and minimal residual astigmatism. The POC study design was supported, demonstrating that prototype non-toric monofocal IOLs can predict clinical performance of toric IOLs with the same haptic design.

Keywords: IOL rotation; astigmatism; axis misalignment; cataract; surgery; toric IOL.

Publication types

Case Reports
Clinical Trial

Grants and funding

This study was supported by Johnson & Johnson Surgical Vision, Inc., which participated in the design and conduct of the study.