Comparison of Rotational Stability Between PanOptix and AT Lisa Trifocal Toric IOLs

Overview

This study compared the rotational stability of two popular trifocal toric intraocular lenses (IOLs)—the PanOptix Toric with C-loop haptics and hydrophobic acrylic material, and the AT Lisa Toric with plate haptics and hydrophilic acrylic material—using the iTrace system. Results showed no statistically significant difference in mean absolute rotation between the two IOL types, although PanOptix demonstrated a trend toward less rotation.

Background

Multifocal trifocal toric IOLs are increasingly used to correct presbyopia and corneal astigmatism during cataract surgery, aiming for spectacle independence at all distances. Rotational stability of toric IOLs is critical because even small degrees of rotation can significantly reduce astigmatic correction and visual quality. Different haptic designs and IOL materials may influence rotational stability, but comparative data are limited. Objective measurement tools like the iTrace system provide efficient and accurate postoperative assessment of IOL alignment.

Data Highlights

Key Findings

• Both PanOptix and AT Lisa trifocal toric IOLs demonstrated good rotational stability postoperatively.
• Mean absolute rotation was 2.3° for PanOptix and 3.1° for AT Lisa, with no statistically significant difference (p=0.12).
• PanOptix IOLs use a C-loop haptic design and hydrophobic acrylic material, which may contribute to slightly better stability.
• AT Lisa IOLs have a plate haptic design and hydrophilic acrylic material, potentially leading to marginally higher rotation.
• The iTrace system provided objective, efficient measurement of IOL alignment, supporting its use in clinical practice.

Clinical Implications

Surgeons can expect both PanOptix and AT Lisa trifocal toric IOLs to provide satisfactory rotational stability in patients with regular corneal astigmatism. The slight trend toward less rotation with PanOptix may guide lens selection in cases where maximal rotational stability is desired. Objective tools like the iTrace system are valuable for routine postoperative assessment to detect and manage any significant IOL rotation.

Conclusion

This comparative study found no significant difference in rotational stability between PanOptix and AT Lisa trifocal toric IOLs, although PanOptix showed a non-significant trend toward less rotation. Both IOLs are suitable options for achieving stable astigmatic correction in cataract surgery.

References

1. Alcon & Carl Zeiss Meditec Clinical Data 2024 -- Rotational Stability of Trifocal Toric IOLs
2. Lee et al. 2023 -- Variability in Toric IOL Rotation Measurements
3. Tracey Technologies Corp. 2024 -- iTrace Surgical Workstation User Guide