This retrospective study used the American Academy of Ophthalmology Registry data to analyse the need of reoperation for realignment within the first year after cataract surgery with a TECNIS or AcrySof monofocal toric IOL implanted during 2016 and 2017. They analysed results for 6482 eyes with monofocal toric IOLs; 4469 (68.94%) were implanted with AcrySof and 2013 (31.06%) with TECNIS IOLs. Repositioning was more common with TECNIS-implanted (3.1%, 62/2013) than in AcrySof implanted (0.6%, 25/4469) eyes (P < .0001). The odds ratio (OR) of repositioning within 365 days of surgery for eyes implanted with TECNIS of 5.57 (95% CI, 3.48-8.92) was comparable to Acrysof IOLs. Logistic regression for risk factors for repositioning showed younger age as the only significant factor with an OR of 0.76 (95% CI, 0.67-0.86) for every five-year increase in age, indicating reduced risk with older age. Sex, race, and region where the surgery was done were not significant. Database studies are limited by possible coding errors, lack of strict selection criteria and potential selection bias. This study provides real world data with a large, pooled sample size and helps guide IOL selection.