Incidence and Outcomes of Repositioning Surgery to Correct Misalignment of Toric Intraocular Lenses.

PURPOSE: To analyze the incidence and appropriate timing of repositioning surgery to correct misalignment of acrylic foldable toric intraocular lenses (IOLs).

DESIGN

Retrospective, multicenter case series.

PARTICIPANTS

Patients who had undergone phacoemulsification and implantation of toric IOL at 8 surgical sites.

METHODS

Patient charts were reviewed to collect data on repositioning surgery of toric IOLs.

MAIN OUTCOME MEASURES: Incidence, timing, and outcomes of repositioning surgery.

RESULTS

Among 6431 eyes implanted with toric IOLs, 42 eyes (0.653%) of 42 patients underwent repositioning surgery at an average of 9.9±7.5 days (range, 0-30 days) after IOL implantation. The repositioning surgery significantly reduced misalignment from 32.9°±15.7° to 8.8°±9.7° (P < 0.001), which was measured at 7.6±5.0 weeks postoperatively. Refractive cylinder was significantly reduced from 2.4±1.1 diopters (D) to 1.1±0.8 D (P < 0.001). There was a significant negative correlation between the interval from cataract surgery to repositioning procedure and the degree of residual misalignment (r = -0.439, P < 0.001). The residual misalignment was 13.1°±13.5° when the repositioning surgery was performed within 6 days after cataract surgery, whereas the residual misalignment was 6.3°±5.9° when the IOL was repositioned 7 days or later (P < 0.001). In 2 eyes that were treated within 24 hours after cataract surgery, the IOL re-rotated significantly, and additional surgical intervention was required.

CONCLUSIONS

Toric IOLs were repositioned in 0.653% of cases. A relationship was found between the timing of repositioning surgery and surgical outcome. These data suggest that repositioning surgery should be performed 1 week after IOL implantation.