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24 | EYEWORLD DAILY NEWS | MAY 16, 2020 DAILY NEWS ASCRS VIRTUAL ANNUAL MEETING Paper in session on toric IOLs looks at rotational stability "All of these findings led to real change with the FDA's ap- proval of the TECNIS Toric II, which has square and frosted haptic edges, which hopefully lead to more rotational stabili- ty," Dr. Kramer said. He noted that the enVis- ta toric IOL entered the U.S. market in 2018. To date, there have been limited studies on rotational stability of this IOL. For this study, Dr. Kramer said they looked at data from 1,706 AcrySof, 1,308 TECNIS, and 224 enVista IOLs that were submitted to the astimatismfix. com database between March 11, 2019 and March 10, 2020. An IOL was determined to have rotated if the difference between intended location and postop location was equal to or greater than 5 degrees. Dr. Kramer noted that be- cause the data in this study is solely from cases with residual astigmatism, the rate of rota- tion in this set is higher than when you consider all toric IOLs. According to this data, AcrySof rotated 72.7% of the time, TECNIS 83.4%, and en- Vista 83%. When you compare the three to each other, the TECNIS lens rotates about 1.9 by Liz Hillman Editorial Co-Director A paper session on toric IOLs tackled a variety of topics related to use of IOLs to address astigmatism at the time of cata- ract surgery. One by Brent Kramer, MD, Chapel Hill, North Carolina, David Hardten, MD, Bloom- ington, Minnesota, and John Berdahl, MD, Sioux Falls, South Dakota, discussed by Dr. Kramer, presented analysis of data from the website astigmatismfix.com. The analysis looked at the rotational trends of the three most commonly used toric IOLs in the U.S., Dr. Kramer said, the enVista (Bausch + Lomb), AcrySof (Alcon), and TECNIS (Johnson & Johnson Vision). Dr. Kramer noted how the astigmatismfix.com database was used to show rotational stability in the AcrySof com- pared to the TECNIS toric. This finding was presented at the 2016 ASCRS Annual Meeting and was later published in peer-reviewed literature. The stability of AcrySof compared to other toric IOLs was con- firmed in other studies as well. received an additional drop of brimonidine 0.15%. All subjects underwent FLACS with the Catalys and White- star Signature Pro (Johnson & Johnson Vision), and all sub- jects had imaging repeated 15 minutes following surgery with the Oculus Keratograph 5M. In the study group, 25 subjects met all inclusion and exclusion criteria for data anal- ysis, along with 37 subjects in the control group. The preoperative bulbar redness score in the study group tended to be higher than in the control group, Dr. Tam said, but it did not reach statis- tical significance. Meanwhile, the postoperative score in the study group was reduced but increased in the control group. However, these postoperative values were not statistically significant between the two groups, he said. When com- paring the change in bulbar redness score from preop to postop, however, a statistically significant difference between the two groups was found. The study group had a reduction in bulbar redness score following FLACS, he said, but the control group had a slight increase. In conclusion, Dr. Tam said that brimonidine 0.15% can significantly reduce sub- conjunctival hemorrhage following FLACS. He noted that this is the first study to evaluate brimonidine effect on subconjunctival hemorrhage following FLACS and to objec- tively quantify subconjunctival hemorrhage. However, he added that the study had sev- eral limitations, including low sample size and a possible con- founding effect of preoperative use of phenylephrine 10% for pupil dilation in both control and study groups. These and more presenta- tions on this topic can be found in SPS-103. Editors' note: Dr. Germano and Dr. Tam have no financial interests related to their presentations. continued from page 22 continued on page 26 times more than the AcrySof, enVista about 1.8 times more than AcrySof. There was no statistical difference in rotation when comparing enVista and TECNIS. In terms of magnitude of rotation, the TECNIS and enVista appeared to rotate farther from target than the AcrySof lens, but Dr. Kram- er said it wasn't a statistical difference. All three models rotated clockwise most of- ten, and Dr. Kramer noted a stronger preference toward counterclockwise rotation in the TECNIS and enVista lens compared to AcrySof. Location subanalysis strat- ified by where the IOL was placed during surgery revealed several things, Dr. Kramer said: 1) TECNIS IOLs placed against the rule, or horizontally, tended to be more stable than those placed vertically or diagonally. While there was no statistical difference in the magnitude of rotation among the three lenses, TECNIS and enVista rotated farther from target than AcrySof toric IOLs. Source: Brent Kramer, MD, screenshot from presentation

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