Rotation Riddle: A Case of Ninety-Degree Rotation of a Plate Haptic Toric Intraocular Lens and Its Management.

The toric intraocular lens (IOL) is the lens of choice for correcting regular corneal astigmatism during cataract surgery. The rotation of the toric IOL frequently encounters challenges, especially in high myopes. In this case report, a patient underwent phacoemulsification surgery with a plate haptic toric IOL implantation to address high myopic astigmatism. However, the patient experienced decreased vision one week postoperatively due to a 90-degree rotation of the toric IOL. We repositioned the IOL to its new orientation using the Berdahl and Hardten Toric IOL calculator. Additionally, a capsular tension ring (CTR) was inserted. The final visual outcome was satisfactory. IOL re-alignment is a safe and efficient way to recover visual acuity in post-operative toric IOL rotation cases. Toric IOL rotational stability is better ensured with the insertion of a CTR in high myopes.