Impact of preoperative ocular biometry and capsulorhexis morphology on the rotational stability of a toric intraocular lens.

INTRODUCTION AND

OBJECTIVES

Despite correct alignment during surgery, postoperative lens rotation remains one of the main complications for toric lenses. This study aimed to evaluate the rotational stability in patients who underwent enVista Toric MX60T intraocular lens implantation and its relationship with the capsulorhexis morphology and preoperative ocular biometrics.

MATERIALS AND

METHODS

59 eyes of 59 patients with cataract and regular corneal astigmatism, who underwent uncomplicated phacoemulsification with enVista Toric MX60T intraocular lens implantation. Pre-op ocular biometrics were evaluated with the IOLMaster 700. 24 h post-surgery, perimeter, area, horizontal and vertical diameter, and circularity index of the capsulorhexis were taken with the ImageJ program through clinical photographs under pupillary dilation. OPD-Scan III was performed post-op at 24 h and at 1 month to quantify lens rotation.

RESULTS

At 1 month post-op, the mean refractive cylinder was of 0.1 ± 0.61 diopters, and the mean lens rotation was of 5.00 ± 3.93 degrees. 52 % of lenses rotated 5° or less. Post-surgical uncorrected visual acuity was 20/30 or better in 64 % of eyes. Logistic regression showed a weak association regarding anterior chamber depth and IOL rotation at 24 h, however, this was not maintained at the 1 month visit. The rest of the parameters showed no correlation regarding lens rotation at any of the time periods.

CONCLUSIONS

The magnitude of rotation of the enVista Toric MX60T intraocular lens is not related to the capsulorhexis morphology or preoperative ocular biometrics. Further research is needed to assess variables that may affect lens rotation, to improve post-surgical visual and refractive outcomes.