Impact of Postoperative Walking vs. Lying Down on IOL Rotation After Lens Surgery: A Prospective Comparative Study

Area of Science:

• Ophthalmology
• Surgical Innovation
• Biomedical Engineering

Background:

• Femtosecond laser-assisted cataract surgery (FLACS) offers precision in lens fragmentation.
• Intraocular lens (IOL) rotational stability is crucial for visual outcomes, especially with astigmatism correction.
• Capsular bag implantation is standard for non-toric IOLs.

Purpose of the Study:

• To evaluate the effect of early postoperative patient positioning on the rotational stability of non-toric intraocular lenses (IOLs).
• To compare IOL rotation in patients who remained supine versus those who ambulated in the first hour post-surgery.

Main Methods:

• A prospective, randomized clinical trial involving 38 eyes of 36 patients undergoing FLACS.
• Patients were randomized into a laid-down (LD) group or a walking (W) group for the first postoperative hour.
• IOL position was measured using retroilluminated slit lamp imaging at baseline, 1 hour, and 1 day postoperatively, analyzed via image processing software.

Main Results:

• No significant difference in IOL rotation was observed between the LD group (1.80° ± 1.80°) and the W group (1.21° ± 2.11°) in the first hour (p=0.123).
• IOL position stability was maintained similarly at one day post-operation, with minimal deviation from baseline in both groups (LD: 1.52° ± 1.89°; W: 1.51° ± 1.69°; p=0.773).

Conclusions:

• Early postoperative patient positioning (supine vs. ambulation) does not significantly influence the rotational stability of non-toric IOLs implanted in the capsular bag.
• These findings suggest that standard clinical practices regarding immediate postoperative patient mobility may not critically affect IOL centration.