Study: Lower-diopter toric IOLs produce good visual acuity results

A small study of the +10 D to +16.5 D lenses yielded no clinically significant rotational issues.

Recently launched lower-diopter toric IOLs did not present rotational problems and produced highly favorable visual acuity results in a study, according to a surgeon.

Cynthia A. Matossian, MD, FACS, discussed her study of the Trulign +10 D to +16.5 D accommodative toric IOLs (Bausch + Lomb) in a presentation at Hawaiian Eye 2017.

“The Trulign toric accommodative implant can deliver excellent results very predictably,” Matossian said. “And [there were] no rotational issues in a very small study with an N of 21.”

The lower-diopter range of toric IOLs was launched roughly a year ago. Before that, Trulign offered the lenses in a range of +17 D to +25 D. They now range from +10 D to +33 D in 0.5 D increments and come with one of three cylinder powers: 1.25 D, 2 D and 2.75 D.

Cynthia A. Matossian

Matossian noted that lower-diopter IOLs are often associated with eyes that have longer axial lengths in which IOL rotational problems can ensue.

“We know that [longer] axial lengths are often associated with bigger capsular bags, therefore possibly making that toric IOL not stay where you put it, leading to rotational issues and unsatisfied patients due to poor or non-ideal visual outcomes,” she said in her presentation.

“I wanted to do a retrospective study and analyze my own data to see how stable these implants were in my patients with high or long axial myopia,” she told Healio.com/OSN.

Matossian conducted a review of charts for consecutive cataract surgeries she had performed on 21 eyes, all of which received the lower-diopter toric lenses. She used neither ORA (Alcon) nor capsular tension rings during any of the procedures, she said.

The preoperative uncorrected distance visual acuity range was 20/50 to counting fingers. The mean axial length was 26 mm, with a range of 24.33 mm to 27.42 mm. Matossian implanted lenses with a cylinder power of 1.25 D in 19% of eyes, 2 D in 52% and 2.75 D in 29%.

At 1 month postoperatively, all eyes had a best corrected distance visual acuity of 20/25 or better. In addition, 95% had both an uncorrected distance visual acuity and an uncorrected intermediate visual acuity at 26 inches of 20/30 or better.

Seventy-six percent of eyes had an uncorrected near visual acuity at 16 inches of 20/30 or better.

All eyes had residual cylinder of 0.5 D or less, and none had a residual refractive error requiring enhancement. The mean residual manifest refraction spherical equivalent was –0.46 D, with a range of 0 D to –1.25 D.

Matossian said none of the lenses had clinically significant rotational issues, vault or Z-syndrome.

Ninety-five percent of eyes came within 0.75 D of their targets, and 76% came within 0.5 D. – by Joe Green

Disclosure: Matossian reports she is a consultant for Bausch + Lomb.

Recently launched lower-diopter toric IOLs did not present rotational problems and produced highly favorable visual acuity results in a study, according to a surgeon.

Cynthia A. Matossian, MD, FACS, discussed her study of the Trulign +10 D to +16.5 D accommodative toric IOLs (Bausch + Lomb) in a presentation at Hawaiian Eye 2017.

“The Trulign toric accommodative implant can deliver excellent results very predictably,” Matossian said. “And [there were] no rotational issues in a very small study with an N of 21.”

The lower-diopter range of toric IOLs was launched roughly a year ago. Before that, Trulign offered the lenses in a range of +17 D to +25 D. They now range from +10 D to +33 D in 0.5 D increments and come with one of three cylinder powers: 1.25 D, 2 D and 2.75 D.

Cynthia A. Matossian

Matossian noted that lower-diopter IOLs are often associated with eyes that have longer axial lengths in which IOL rotational problems can ensue.

“We know that [longer] axial lengths are often associated with bigger capsular bags, therefore possibly making that toric IOL not stay where you put it, leading to rotational issues and unsatisfied patients due to poor or non-ideal visual outcomes,” she said in her presentation.

“I wanted to do a retrospective study and analyze my own data to see how stable these implants were in my patients with high or long axial myopia,” she told Healio.com/OSN.

Matossian conducted a review of charts for consecutive cataract surgeries she had performed on 21 eyes, all of which received the lower-diopter toric lenses. She used neither ORA (Alcon) nor capsular tension rings during any of the procedures, she said.

The preoperative uncorrected distance visual acuity range was 20/50 to counting fingers. The mean axial length was 26 mm, with a range of 24.33 mm to 27.42 mm. Matossian implanted lenses with a cylinder power of 1.25 D in 19% of eyes, 2 D in 52% and 2.75 D in 29%.

At 1 month postoperatively, all eyes had a best corrected distance visual acuity of 20/25 or better. In addition, 95% had both an uncorrected distance visual acuity and an uncorrected intermediate visual acuity at 26 inches of 20/30 or better.

Seventy-six percent of eyes had an uncorrected near visual acuity at 16 inches of 20/30 or better.

All eyes had residual cylinder of 0.5 D or less, and none had a residual refractive error requiring enhancement. The mean residual manifest refraction spherical equivalent was –0.46 D, with a range of 0 D to –1.25 D.

Matossian said none of the lenses had clinically significant rotational issues, vault or Z-syndrome.

Ninety-five percent of eyes came within 0.75 D of their targets, and 76% came within 0.5 D. – by Joe Green

Disclosure: Matossian reports she is a consultant for Bausch + Lomb.