Validating clinical outcomes through long-term rotational stability

Matching expectations of visual acuity

Clinical challenge

After toric IOL surgery, patients expect to have good uncorrected visual acuity without the use of glasses for distance. Astigmatic power surprises, e.g. over- or undercorrection, mostly arise from upfront errors in corneal measurements. However, ensuring long-term rotational stability of the IOL represents the most crucial aspect in daily routine. A relatively small misalignment in toric lens placement can result in significant loss of the astigmatic refractive effect.1

Easily assessing the IOL positioning

Clinical solution

Utilizing a comprehensive workflow and solid measurement data taking posterior corneal astigmatism into account, reduces the risk for astigmatic power surprises. To ensure rotational stability, a routine checkup assesses the positioning of the toric IOL whenever an accurate refraction can be obtained post-surgery. While subjective refraction provides a good indication, a slit lamp examination can show more details regarding IOL positioning.

  • Clinical solutions for managing astigmatic refractive surprise

Examining IOL position with extensive illumination options

ZEISS solution

The 4-haptic design of ZEISS toric IOLs has been clinically validated in terms of high degree of long-term rotational stability.2 To ensure the precise alignment, the SL 800 slit lamp from ZEISS enables you to uncover all the details regarding the exact toric IOL positioning in your preferred examination light. Toric marks on ZEISS toric IOLs are easily identifiable.  In case of realigning the misaligned toric IOL, there is a trend showing that calculating the realignment axis using the ZEISS IOLMaster 700 TK technology can significantly reduce the residual refractive astigmatism compared to different formulas.3

ZEISS IOLMaster 700

ZEISS SL 800 & SL Imaging Solution

With perfectly balanced ZEISS optics, extensive illumination options and a user-friendly operator concept directly at your fingertips, the ZEISS SL 800 reveals details to e.g. check the correct alignment of toric IOLs.

  • The VarioLight cold white feature benefits scattering and helps to identify irregularities within the anterior segment
  • ZEISS SL Imaging Solution provides high-quality images and video captures for documentation, patient education or publishing

Comprehensive workflow to make treating astigmatism your new standard of care

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  • 1

    Ma, J. J. K. (2009). Principles and Pearls in Toric Marking and Alignment. Retrieved from website:

  • 2

    Mencucci, R., Favuzza, E., Guerra, F., Giacomelli, G., & Menchini, U. (2014). Clinical outcomes and rotational stability of a 4-haptic toric intraocular lens in myopic eyes. J Cataract Refract Surg, 40(9), 1479-1487. doi:10.1016/j.jcrs.2013.12.024

  • 3

    Sharma, A. C., & Khetan, A. (2022). Comparing IOLM700 TK, Berdahl and Hardten astigmatism fix calculator and Barrett Rx formula in managing residual astigmatism due to toric intraocular lens misalignment. Indian J Ophthalmol, 70(2), 413-419. doi:10.4103/ijo.IJO_1760_21