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Active, not recruitingNCT07768722Updated Aug 17, 2026

Influence of Implantation Technique on Rotational Stability of a Frosted-Haptic Toric Intraocular Lens: A Prospective Contralateral-Eye Study

An interventional study of OVD-assisted Implantation and BSS-assisted hydroimplantation in Cataract With Pre-existing Regular Corneal Astigmatism, sponsored by Ain Shams University. Active, not recruiting at 1 site in Egypt. Per ClinicalTrials.gov, last updated 2026-08-17.

Sponsored by Ain Shams University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Sex
All
01

Study summary

This prospective, randomized contralateral-eye study evaluates whether the implantation technique influences the rotational stability and refractive outcomes of the TECNIS Eyhance™ Toric II intraocular lens (IOL) during cataract surgery. Although balanced salt solution (BSS) hydroimplantation has been proposed to reduce postoperative IOL rotation by eliminating retained ophthalmic viscosurgical device (OVD), the effect of implantation technique on the rotational stability of modern frosted-haptic toric IOLs remains uncertain.

Patients undergoing bilateral cataract surgery with regular corneal astigmatism receive TECNIS Eyhance™ Toric II IOLs in both eyes. One eye is randomized to OVD-assisted implantation and the fellow eye to BSS-assisted hydroimplantation. The primary outcome is postoperative rotational stability assessed using OPD-Scan III at postoperative day 1, week 1, and month 1. Secondary outcomes include postoperative refractive astigmatism, astigmatic prediction error, and visual acuity. The study aims to determine whether implantation technique influences postoperative rotational stability or refractive performance when using a contemporary frosted-haptic toric IOL.

02

Conditions studied

  • Cataract With Pre-existing Regular Corneal Astigmatism

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Keywords

  • Cataract surgery
  • Toric Intraocular Lens
  • TECNIS Eyhance Toric II
  • Rotational Stability
  • Hydroimplantation
  • Balanced Salt Solution (BSS)
  • Ophthalmic Viscosurgical Device (OVD)
  • Corneal Astigmatism
  • Refractive Outcomes
  • Intraocular Lens Implantation
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults with senile cataract requiring bilateral cataract surgery.
  • Regular corneal astigmatism of ≥1.00 diopter.
  • Axial length between 22.0 mm and 25.0 mm.
  • Eligible for implantation with the TECNIS Eyhance™ Toric II intraocular lens.
  • Able and willing to provide written informed consent.

Exclusion criteria

Exclusion Criteria:

  • Inconsistent corneal astigmatism measurements (difference >0.20 D in magnitude or >5° in axis among the four diagnostic devices).
  • Visually significant dry eye disease with positive corneal fluorescein staining.

Irregular corneal astigmatism or corneal opacity.

  • Ocular comorbidities that could affect toric IOL stability or visual outcomes (e.g., pseudoexfoliation syndrome, advanced glaucoma, or macular pathology).
  • Intraoperative complications or generalized zonular weakness requiring implantation of a capsular tension ring.
  • Significant postoperative day 1 corneal edema precluding reliable rotational measurements.
  • Inability to comply with the follow-up schedule.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
80 participants (actual)

Study arms

  • Experimental
    OVD-assisted Implantation

    Implantation of the TECNIS Eyhance Toric II intraocular lens using a cohesive ophthalmic viscosurgical device (ProVisc) during cataract surgery.

    Procedure: OVD-assisted Implantation

  • Experimental
    BSS-assisted hydroimplantation

    Implantation of the TECNIS Eyhance Toric II intraocular lens using balanced salt solution hydroimplantation during cataract surgery.

    Procedure: BSS-assisted hydroimplantation

Interventions

  • ProcedureOVD-assisted Implantation

    Implantation of the TECNIS Eyhance Toric II intraocular lens using a cohesive ophthalmic viscosurgical device.

  • ProcedureBSS-assisted hydroimplantation

    Implantation of the TECNIS Eyhance Toric II intraocular lens using balanced salt solution instead of an ophthalmic viscosurgical device.

05

What researchers measure

Primary outcomes

  1. Absolute rotational stability of the TECNIS Eyhance Toric II intraocular lens

    Absolute intraocular lens rotation (degrees) measured relative to the final intraoperative implantation axis using the OPD-Scan III. Rotation was calculated as the absolute angular difference between the intraoperative reference axis and the postoperative axis

    Time frame: Postoperative day 1, week 1, and month 1

Secondary outcomes

  1. Residual refractive astigmatism

    Postoperative refractive astigmatism measured at the corneal plane by manifest refraction.

    Time frame: 3 months after surgery

  2. Astigmatic prediction error

    Absolute prediction error calculated as the absolute difference between the predicted and postoperative refractive astigmatism.

    Time frame: 3 months after surgery

  3. Uncorrected Distance Visual Acuity (UDVA)

    Monocular uncorrected distance visual acuity measured using a standardized visual acuity chart.

    Time frame: 3 months after surgery

  4. Corrected Distance Visual Acuity (CDVA)

    Time frame: 3 months after surgery

06

Study locations

1 site
  • Ainshams University
    Cairo, Dr. 11765, Egypt
07

Registry details

Key details

Study ID
NCT07768722
Lead sponsor
Ain Shams University
Collaborators
Al Watany Eye Hospital
Responsible party
Menna Kamel (Assistant Lecturer, Ain Shams University) — Principal investigator
First posted
Aug 17, 2026
Start date
Apr 10, 2026
Primary completion
Jun 10, 2026
Completion
Aug 30, 2026 (estimated)
Last update
Aug 17, 2026

Study contacts

Ahmed Assaf, MD, PhD
principal investigator · Ainshams University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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