Altos Eye Physicians, Los Altos, California.
Altos Eye Physicians, Los Altos, California; University of California San Francisco, San Francisco, California.
Ophthalmology. 2018 Sep;125(9):1325-1331. doi: 10.1016/j.ophtha.2018.02.012. Epub 2018 Mar 12.
To compare the rotational stability of the 2 most commonly used toric intraocular lenses (TIOLs).
Retrospective cohort study in a single private practice.
The study included all patients receiving an Acrysof (n = 626) or Tecnis TIOL (n = 647) over an 18-month period from April 2015 to September 2016. Patients were only excluded if their surgery could not be performed using a digital marking system.
All patients had cataract surgery performed in the same surgical center with a similar technique. A digital marking system with limbal vessel registration was used to record the axis of the TIOL at the conclusion of surgery. A dilated examination was performed either later on the day of surgery or the next morning, and the postoperative rotation of the 2 TIOL models was compared. Patients who required a return to the operating room for TIOL repositioning were examined to determine risk factors for reoperation and subsequent outcomes.
The primary outcome measure was the percentage of eyes with TIOL rotation >5 and >10 degrees. The second main outcome was likelihood of requiring return to the operating room to reposition a rotated TIOL.
The Acrysof TIOL was less likely to rotate postoperatively, with 91.9% of eyes rotated ≤5 degrees at the first postoperative check compared with 81.8% of Tecnis TIOL eyes (P < 0.0001). This difference persisted for rotation ≤10 degrees (97.8% Acrysof vs. 93.2% Tecnis, P = 0.0002) and ≤15 degrees (98.6% Acrysof vs. 96.4% Tecnis, P = 0.02). The mean rotation was 2.72 degrees (95% confidence interval 2.35-3.08 degrees) for Acrysof and 3.79 degrees (95% confidence interval 3.36-4.22 degrees) for Tecnis TIOLs (P < 0.05). The Tecnis TIOL showed a strong predisposition to rotate counterclockwise, unlike the Acrysof. More Tecnis TIOL patients required repositioning (3.1% vs. 1.6%), but this did not reach statistical significance (P = 0.10). Refractive outcomes were similar between the 2 groups.
The Acrysof TIOL showed significantly greater rotational stability than the Tecnis TIOL.
比较两种最常用的散光人工晶状体（TIOI）的旋转稳定性。
单一家族实践的回顾性队列研究。
这项研究包括在 2015 年 4 月至 2016 年 9 月的 18 个月期间接受 Acrysof（n=626）或 Tecnis TIOL（n=647）的所有患者。如果他们的手术无法使用数字标记系统进行，患者将被排除在外。
所有患者均在同一家手术中心接受了类似技术的白内障手术。使用带有角膜缘血管登记的数字标记系统来记录手术结束时 TIOL 的轴。在手术当天或次日早上进行散瞳检查，并比较两种 TIOL 模型的术后旋转情况。需要返回手术室重新定位 TIOL 的患者接受检查，以确定再次手术的风险因素和随后的结果。
主要观察指标是 TIOL 旋转>5 和>10 度的眼睛百分比。第二个主要结果是需要返回手术室重新定位旋转 TIOL 的可能性。
Acrysof TIOL 术后旋转的可能性较小，与 Tecnis TIOL 眼相比，第一次术后检查时旋转≤5 度的眼为 91.9%（P<0.0001）。这种差异在旋转≤10 度（97.8% Acrysof 对 93.2% Tecnis，P<0.0002）和旋转≤15 度（98.6% Acrysof 对 96.4% Tecnis，P=0.02）时仍然存在。Acrysof 的平均旋转为 2.72 度（95%置信区间 2.35-3.08 度），而 Tecnis TIOL 的平均旋转为 3.79 度（95%置信区间 3.36-4.22 度）（P<0.05）。与 Acrysof 不同，Tecnis TIOL 显示出强烈的逆时针旋转倾向。需要重新定位的 Tecnis TIOL 患者更多（3.1%对 1.6%），但这没有达到统计学意义（P=0.10）。两组的屈光结果相似。
Acrysof TIOL 的旋转稳定性明显大于 Tecnis TIOL。
