Intraocular lens rotational stability after cataract surgery with and without primary posterior continuous...

To evaluate intraocular lens (IOL) rotational stability and capsular fusion process after cataract surgery with and without primary posterior continuous curvilinear capsulorhexis (PPCCC).

Fujian Provincial Hospital, Fujian, China.

Prospective, intraindividual, randomized clinical trial.

This study included 56 adult patients (112 eyes) with bilateral cataract undergoing phacoemulsification cataract surgery with PPCCC in 1 eye (PPCCC group) and conventional cataract surgery in the contralateral eye (NPCCC group). IOL axis orientation and fusion footprint length were measured at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively using OPD-Scan III, while the capsular bend index (CBI) was assessed at the same timepoints using Pentacam AXL.

No between-group difference was found in the absolute rotation from 1 day to 1 year (2.93 ± 1.72 vs 2.66 ± 1.61 degrees, P = .54). The absolute rotation from 1 week to 1 month in the NPCCC group was higher than that in the PPCCC group (1.65 ± 0.68 vs 1.27 ± 0.32 degrees, P = .01). At 1 month postoperatively, both fusion footprint length (9.11 ± 2.74 vs 10.67 ± 2.06 mm, P = .02) and CBI (2.92 ± 0.60 vs 3.25 ± 0.59, P = .03) were lower in the NPCCC group.

Cataract surgery involving PPCCC demonstrated comparable outcomes with conventional procedures regarding long-term IOL rotational stability and therefore is a promising option for adult patients with cataract scheduled for toric IOL implantation. PPCCC slightly reduces IOL rotation in the early postoperative period, which can be attributed to accelerated capsular fusion.