Abstract
Purpose
To assess the effect of capsular bend and axial length on the rotational stability of toric IOL.
Methods
The prospective study included patients with preexisting astigmatism that were implanted with Acrysof IQ Toric IOL. According to the pre‑operative axial length, all patients were divided into 2 groups: high myopia (AL ≥ 26 mm) group, and emmetropia or low to moderate myopia group (AL <26 mm). High-speed Swept-source Optical Coherence Tomography (SS-OCT) radial scanning was performed after pupil dilation to obtain the toric IOL axial orientation and capsular bending index (CBI) at 1-day, 1-week, 1-month and 3-month intervals postoperatively. The correlation between the rotation of toric intraocular lens and the axial length or CBI was subsequently analyzed.
Results
68 eyes of 57 patients were included in the research. The rotation of toric IOL within the high myopia group was greater than the control group (P = 0.001, 1month postoperative). Capsular contact with the IOL was delayed in highly myopic eyes, although the results were not statistically significant (P = 0.094, 1-month postoperatively). There was a positive correlation between the degree of rotation and axial length at the interval found between 1-week and 1-month after the operation (r = 0.333, P = 0.005). There was a significant negative correlation between the IOL rotational speed and CBI (P < 0.001). The regression equation was Y = −0.441*X + 1.712 (R2 = 0.323, P < 0.001).
Conclusion
There was a significant negative correlation between the IOL rotation speed and the CBI, while the influence of the axial length and capsular bending mainly occurred between one week and one month after the operation.
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References
Hoffmann PC, Hutz WW. Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes. J Cataract Refract Surg. 2010;36:1479–85.
Yu JG, Zhong J, Mei ZM, Zhao F, Tao N, Xiang Y. Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China. BMC Ophthalmol. 2017;17:56.
Yang LH, Tang X. The research progress in treating astigmatism at the time of cataract surgery. Zhonghua Yan Ke Za Zhi. 2011;47:573–6.
Alpins NA. Vector analysis of astigmatism changes by flattening, steepening, and torque. J Cataract Refract Surg. 1997;23:1503–14.
Visser N, Bauer NJ, Nuijts RM. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013;39:624–37.
Zhu X, He W, Zhang K, Lu Y. Factors influencing 1-year rotational stability of AcrySof Toric intraocular lenses. Br J Ophthalmol. 2016;100:263–8.
Zhao Y, Li J, Lu W, Chang P, Lu P, Yu F, et al. Capsular adhesion to intraocular lens in highly myopic eyes evaluated in vivo using ultralong-scan-depth optical coherence tomography. Am J Ophthalmol. 2013;155:484–91. e481
Nishi O, Nishi K, Akura J. Speed of capsular bend formation at the optic edge of acrylic, silicone, and poly(methyl methacrylate) lenses. J Cataract Refract Surg. 2002;28:431–7.
Meng J, He W, Rong X, Miao A, Lu Y, Zhu X. Decentration and tilt of plate-haptic multifocal intraocular lenses in myopic eyes. Eye Vis. 2020;7:17.
Chang P, Li X, Chen D, Xu Z, Ding X, Zhao YE. The relationship between the change of intraocular lens position and capsular bend after cataract surgery. J Refract Surg. 2021;37:324–30.
Fang Y, Xixia D, Jin L, Lei L, Pingjun C, Hongfang Z, et al. Relationship of posterior capsular opacification and capsular bend type investigation based on swept-source optical coherence tomography. Curr Eye Res. 2020;45:17–23.
Lee BS, Chang DF. Comparison of the rotational stability of two toric intraocular lenses in 1273 consecutive eyes. Ophthalmology. 2018;125:1325–31.
Koshy JJ, Nishi Y, Hirnschall N, Crnej A, Gangwani V, Maurino V, et al. Rotational stability of a single-piece toric acrylic intraocular lens. J Cataract Refract Surg. 2010;36:1665–70.
Guo T, Gao P, Fang L, Guo L, Fan Y, Liu C. Efficacy of Toric intraocular lens implantation in eyes with high myopia: a prospective, case-controlled observational study. Exp Ther Med. 2018;15:5288–94.
Farooqui JH, Koul A, Dutta R, Shroff NM. Comparison of two different methods of preoperative marking for toric intraocular lens implantation: bubble marker versus pendulum marker. Int J Ophthalmol. 2016;9:703–6.
Patel CK, Ormonde S, Rosen PH, Bron AJ. Postoperative intraocular lens rotation: a randomized comparison of plate and loop haptic implants. Ophthalmology. 1999;106:2190–5. discussion 2196
Shah GD, Praveen MR, Vasavada AR, Vasavada VA, Rampal G, Shastry LR. Rotational stability of a toric intraocular lens: influence of axial length and alignment in the capsular bag. J Cataract Refract Surg. 2012;38:54–59.
Schartmuller D, Schriefl S, Schwarzenbacher L, Leydolt C, Menapace R. True rotational stability of a single-piece hydrophobic intraocular lens. Br J Ophthalmol. 2019;103:186–90.
Klamann MK, Von Sonnleithner C, Gonnermann J, Maier AK, Torun N, Bertelmann E. Influence of biometric parameters on rotational stability of toric IOLs. Eur J Ophthalmol. 2013;23:836–40.
Chang DF. Repositioning technique and rate for toric intraocular lenses. J Cataract Refract Surg. 2009;35:1315–6.
Miyake T, Kamiya K, Amano R, Iida Y, Tsunehiro S, Shimizu K. Long-term clinical outcomes of toric intraocular lens implantation in cataract cases with preexisting astigmatism. J Cataract Refract Surg. 2014;40:1654–60.
Ruhswurm I, Scholz U, Zehetmayer M, Hanselmayer G, Vass C, Skorpik C. Astigmatism correction with a foldable toric intraocular lens in cataract patients. J Cataract Refract Surg. 2000;26:1022–7.
Tehrani M, Dick HB, Krummenauer F, Pfirrmann G, Boyle T, Stoffelns BM. Capsule measuring ring to predict capsular bag diameter and follow its course after foldable intraocular lens implantation. J Cataract Refract Surg. 2003;29:2127–34.
Oshika T, Fujita Y, Hirota A, Inamura M, Inoue Y, Miyata K, et al. Comparison of incidence of repositioning surgery to correct misalignment with three toric intraocular lenses. Eur J Ophthalmol. 2020;30:680–4.
Oshika T, Inamura M, Inoue Y, Ohashi T, Sugita T, Fujita Y, et al. Incidence and outcomes of repositioning surgery to correct misalignment of toric intraocular lenses. Ophthalmology. 2018;125:31–35.
Hayashi H, Hayashi K, Nakao F, Hayashi F. Elapsed time for capsular apposition to intraocular lens after cataract surgery. Ophthalmology. 2002;109:1427–31.
Xixia D, Pingjun C, Hongfang Z, Giacomo S, Jinhai H, Feixue C, et al. Three-dimensional morphology study of capsule in pseudophakic eyes with high-speed swept-source optical coherence tomography. Curr Eye Res. 2019;44:607–13.
Sasaki K, Eguchi S, Miyata A, Nishimura T, Miyata K, Hasegawa Y, et al. Anterior capsule coverage and rotational stability of an acrylic toric intraocular lens. J Cataract Refract Surg. 2021;47:618–21.
Li S, Li X, He S, Zheng Q, Chen X, Wu X, et al. Early Postoperative Rotational stability and its related factors of a single-piece acrylic toric intraocular lens. Eye. 2020;34:474–9.
Funding
This study was supported by Medical and Health Science and Technology Project of Zhejiang Province (2018KY538) and Zhejiang Provincial health leading talent project.
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PJC and DJC conceived and designed the presented study. BH, YLW and SYQ performed the data collection. PJC and DJC performed the analysis and wrote the manuscript. XXD and YEZ provided a critical review of the manuscript.
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Chang, P., Chen, D., Hu, B. et al. Effect of capsular bend on the rotational stability of toric intraocular lens. Eye 37, 480–485 (2023). https://doi.org/10.1038/s41433-022-01964-0
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DOI: https://doi.org/10.1038/s41433-022-01964-0
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