Rotation of Hydrophobic Acrylic Lenses - Rayner RA0800C & Alcon Clareon & Hoya Nanex & Hoya Vivinex XY1-EM & RayOne EMV Toric & PODEYE Toric

• Intraocular Lens Implantation (Device): Implantation of an intraocular lens Rayner RayOne or Hoya Nanex or Hoya Vivinex Impressinto the capsular bag using an injector, after removing of the human cristalline lens. Implantation of the Alcon Clareon toric and Rayner RayOne EMV toric IOL and PODEYE Toric IOL on the axis according to the steep meridian of the cornea

Primary outcomes

• Change of axial intraocular lens position [7 months]: Change in axis position of an intraocular lens Rayner RayOne or Hoya Nanex or Hoya Vivinex Impress or Alcon Clareon toric or Rayner RayOne EMV toric or PODEYE Toric from end of surgery (baseline axis) to 1 hour, 1 week, 1 month and 4-7 months (end of study visit). The change in axis position will be evaluated with respect to the baseline measurement at the end of surgery. Differences in axis position will be described as rotation in degrees (0 to 360°)

Secondary outcomes

• Decentration [7 months]: Decentration of the intraocular lens Rayner RayOne or Hoya Nanex or Hoya Vivinex Impress or Alcon Clareon toric or Rayner RayOne EMV toric or PODEYE Toric will be measured with the Casia 2 OCT. Decentration will be described as "Decentration in milimeter"
• Tilt [7 months]: Tilt of the intraocular lens Rayner RayOne or Hoya Nanex or Hoya Vivinex Impress or Alcon Clareon toric or Rayner RayOne EMV toric or PODEYE Toric will be measured with the Casia 2 OCT. Tilt will be described as "Tilt in degrees at a certain axis"
• Anterior chamber depth [1 month]: The anterior chamber depth (Axial position of the IOL) of the intraocular lens Rayner RayOne or Hoya Nanex or Hoya Vivinex Impress or Alcon Clareon or Rayner RayOne EMV toric or PODEYE Toric will be measured with the Casia 2 OCT after 1 month. The anterior chamber depth will be measured in milimeter
• Best corrected visual acuity (BCVA) [7 months]: BCVA will be measured at 1 week, 1 month and 4 to 7 months. The BCVA will be described as the minimum angle of resolution (logMar)
• UCIVA in the Alcon Clareon toric and Rayner RayOne EMV toric groups [7 months]: Uncorrected Intermediate Visual Acuity mono or bilateral

Sex: All, ages: 45 Years to 95 Years

Inclusion Criteria:

* Uni- or bilateral age-related cataract necessitating phacoemulsification extraction and posterior IOL implantation
* Age: 45 to 95
* Need for spherical IOL correction between 10.00 and 30.00 D
* Need for spherical IOL correction between +6.00 and +30.00 D (Alcon Clareon toric group)
* Need for spherical IOL correction between +10.00 and +25.00 D (Rayner RayOne EMV toric group)
* Preoperative pupil dilation in mydriasis ≥ 7.0 mm (Hoya, Rayner groups)
* Astigmatism of at least 1.0 Diopters (Alcon Clareon toric and Rayner RayOne EMV toric groups and PODEYE Toric)
* Pupil dilation >5.5mm (Alcon Clareon toric Rayner RayOne EMV toric group)

Exclusion Criteria:

* Preceding ocular surgery or trauma

  * Recurrent intraocular inflammation of unknown etiology
  * Uncontrolled glaucoma
  * Uncontrolled systemic or ocular disease
  * Blind fellow eye
  * Microphthalmus
  * Corneal abnormality (Corneal scaring)
  * History of uveitis/iritis
  * Iris neovascularization
  * Proliferative diabetic retinopathy
  * Pregnancy
  * Lactation
  * Females of childbearing age will be asked if pregnancy is possible

• Results publication: Lisy M, Danzinger V, Schranz M, Mahnert N, Abela-Formanek C, Leydolt C, Menapace R, Schartmuller D. Assessing postoperative toric intraocular lens rotation: comparative analysis. J Cataract Refract Surg. 2025 Mar 1;51(3):196-203. doi: 10.1097/j.jcrs.0000000000001585. PMID 39602338
• Results publication: Schartmuller D, Lisy M, Mahnert N, Schranz M, Danzinger V, Schwarzenbacher L, Pieh S, Abela-Formanek C, Leydolt C, Menapace R. Rotational stability and refractive outcomes of a new hydrophobic acrylic toric intraocular lens. Eye Vis (Lond). 2024 Jul 2;11(1):25. doi: 10.1186/s40662-024-00393-2. PMID 38951940

• Rupert Menapace, Prof.Dr., Principal investigator, Medical University of Vienna