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Analysis of trends from astigmatismfix for the first assessment of the rotational stability of the enVista Toric IOL (Bausch + Lomb) compared to the AcrySof Toric (Alcon) and Tecnis Toric (J&J) monofocal IOLs.
Retrospective review of entries made to the astigmatismfix.com website will be filtered and analyzed. Rotation/misalignment will be defined as and IOL >5° from the intended axis. The rate of rotation/misalignment will be determined by comparing the amount of entries to their respective rate of background residual astigmatism entries (an ‘internal validation’ method that has been used in previous astigmatismfix studies).
From 9/5/2013 through 12/31/19 there were 28,791 entries to the AstigmatismFix website which were deemed to represent actual patients through a filtering process previously described. The overall rate of rotation was 72.9. There was a statistically significant trend of increasing rotation per year. A subset from 3/2019 through 12/2019 was used to compare rotation rates from three common monofocal toric IOLs. The rates of rotation for AcrySof, TECNIS, and enVista were 73.4%, 83.9%, and 83.0% respectively. The enVista and TECNIS IOLs were found to rotate 1.77x and 1.89x more than the AcrySof IOLs (p <0.001).
The overall increase in toric rotation over the years in the AstigmatismFix database is likely relative and secondary to better pre-operative measurements and calculations. The AcrySof toric IOL remains the most stable toric IOL when compared to the TECNIS toric (ZCTx) and enVista toric (MX60T).