The influence of a modified haptic on preventing toric IOL rotation in high rotation risk eyes

To evaluate the rotational stability and astigmatic correction of a C-loop frosted haptic toric intraocular lens (IOL) compared with a plate-haptic toric IOL with/without capsular tension ring (CTR) implantation in cataractous eyes with high rotation risk due to large white-to-white (WTW) distance.

This retrospective cohort study included 90 cataractous eyes with WTW > 11.8 mm, which received implantation of either a C-loop frosted haptic toric IOL (Group ZCU), a plate-haptic toric IOL (Group 709), or a plate-haptic toric IOL with CTR (Group 709 + CTR). IOL rotation and residual astigmatism were assessed one month postoperatively.

Group ZCU demonstrated significantly better rotational stability, with a mean rotation of 1.87° ± 1.03°, compared to 4.63° ± 2.12° in Group 709 and 4.13° ± 1.86° in Group 709 + CTR (both P < 0.05). Residual astigmatism was also significantly lower in Group ZCU (0.36 ± 0.26 D), compared to Group 709 (0.54 ± 0.43 D) and Group 709 + CTR (0.65 ± 0.27 D; both P < 0.05). A positive correlation between WTW and IOL rotation was found in Group 709 (r = 0.419, P = 0.021) and Group 709 + CTR (r = 0.403, P = 0.027), but not in Group ZCU (r = -0.180, P = 0.341). Lens thickness and WTW were identified as independent predictors of rotation in Group 709, whereas only WTW was significant in Group 709 + CTR.

In eyes with high rotation risk due to large WTW (> 11.8 mm), the ZCU IOL exhibits superior rotational stability and astigmatic correction compared to the 709 IOL, regardless of whether CTR is used.