Work

Comparative analysis of three toric intraocular lenses: clinical outcomes and rotational stability in patients with corneal astigmatism

Year: 2025

Type: article

Abstract: s : This study aims to evaluate the clinical outcomes and rotational stability of three different toric intraocular lenses (IOLs; Tecnis ZCT, Tecnis ZCU and AcrySof IQ) used in femtosecond laser-assisted cataract surgery (FLACS) and investigate potential variables that may impact the rotational stability. This retrospective study involved 126 eyes from 111 patients who received FLACS with toric IOL implantation. Patients were allocated to three groups: one received the AcrySof IQ toric IOL, another the Tecnis ZCT, and the other the Tecnis ZCU. Ophthalmic parameters such as axial length (AL), anterior chamber depth (ACD), and white-to-white (WTW) distance, were determined preoperatively. Postoperative evaluations were conducted at 3 months. No significant differences in BCDVA or residual astigmatism (RAS) postoperatively were observed among the groups ( P >0.05). No significant differences were found among the three toric IOLs in mean absolute rotation or directional distribution ( P > 0.05). In eyes with axial length≥24.00mm, the Tecnis ZCT toric IOL demonstrated significantly poorer rotational stability compared to the AcrySof IQ (Tecnis ZCT: 6.41±5.23 degrees, AcrySof IQ: 3.40±2.95 degrees, P =0.032). Pairwise comparisons showed significant differences in capsule-IOL overlap between the AcrySof IQ and Tecnis ZCT groups ( P =0.014), as well as between the Tecnis ZCT and Tecnis ZCU groups ( P < 0.001), but not between the AcrySof IQ and Tecnis ZCU ( P =0.187). There was no significant difference ( P > 0.05) in IOL decentration among the three groups. In the Tecnis ZCT group, toric IOL rotation demonstrated a statistically significant association with the WTW distance (Pearson’s r=0.313, P =0.034). For Tecnis ZCU, a significant correlation was observed between toric IOL rotation and the AL (Pearson’s r=0.325, P =0.041), The three toric IOLs showed comparable visual and refractive outcomes at 3 months. The Tecnis ZCT demonstrated inferior performance in rotational stability and postoperative alignment compared to the AcrySof IQ and Tecnis ZCU.

Source: Advances in Ophthalmology Practice and Research

DOI: 10.1016/j.aopr.2025.10.007