Incidence and Risk Factors of Repositioning Surgery to Correct Misalignment of Toric Intraocular Lenses after Cataract Surgery: A Single-Center Retrospective Observational Study

Abstract

Purpose: To analyze the incidence and outcomes of repositioning surgery to correct misalignment of several toric intraocular lenses (IOLs) after cataract surgery. Methods: In this retrospective study, patients who underwent repositioning surgery to correct misalignment of toric IOLs following cataract surgery between January 2019 and December 2021 were enrolled. The medical data on patients' age, gender, preoperative axial length, corneal astigmatism, the axis of astigmatism, IOL models, IOL axis, uncorrected distance visual acuity, residual refraction, and postoperative outcomes were analyzed. Results: Among the 1135 eyes implanted with toric IOLs at Qingdao Eye Hospital, 23 (2.026%, 23/1135) underwent repositioning surgery. Univariate analysis revealed that the incidence of repositioning surgery was significantly lower with AcrySof (0.636%, 5/786) than with ZEISS (2.959%, 5/169) and TECNIS (7.222%, 13/180) IOL platforms; The incidence of repositioning surgery with monofocal toric IOLs (1.169%, 11/941) was significantly lower than multifocal toric IOLs (6.186%, 12/194) (P<0.001); Additionally, a significant difference in age was also observed (P=0.002). Multivariate logistic regression analysis showed that IOL platform (P=0.004) and younger age (P=0.006) were independent risk factors for repositioning surgery. Conclusion: The incidence of repositioning surgery of toric IOLs after cataract surgery was 2.026%. It was linked to the IOL platform, multifocal toric IOLs, and younger age.

Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power

“…In addition, the incidence of ≥10 degrees of spontaneous rotation over time has been reported to be 2% to 7% in patients implanted with TIOLs after standard cataract surgery, even without any additional capsulotomy. 29 Therefore, in addition to Nd:YAG laser capsulotomy-induced rotation, spontaneous rotation may also play a role in our findings.…”