Rotational Stability and Refractive Outcomes of a Toric Hydrophilic Acrylic Intraocular Lens

To assess rotational stability and refractive outcomes of a toric hydrophilic acrylic intraocular lens (IOL).

Single-center, noncomparative, interventional clinical trial.

In this study, 120 eyes from 80 patients with age-related cataract and preoperative corneal astigmatism greater than 1.0 diopter (D) were enrolled. Patients underwent phacoemulsification with implantation of a RayOne EMV Toric IOL. Rotational stability was evaluated relative to baseline measurements at the end of surgery (EOS) and compared to retroillumination images acquired at 1 hour (1 h), 1 week (1 w), 1 month (1 m), and 6 months (6 m), postoperatively. Subjective manifest refraction was assessed at the 6 m follow-up visit.

A total of 114 eyes from 75 patients were available for the final analysis. Mean absolute rotation from EOS to 6 m was 2.44° ± 2.34° (range: 0.04; 10.60). Rotation between follow-up visits was 0.89° ± 1.10° (0.00; 8.37) from EOS to 1 h, 0.58° ± 0.49° (0.00; 2.76) from 1 h to 1 w, 1.19° ± 1.45° (0.02; 7.17) from 1 w to 1 m, and 1.11° ± 1.41° (0.00; 7.96) from 1 m to 6 m. Preoperative corneal astigmatism was 1.68 ± 0.66 D (1.00; 3.99), which was reduced to a postoperative refractive astigmatism of 0.27 ± 0.26 D (0.00; 1.25) at 6 m.

The RayOne EMV Toric IOL demonstrated good rotational stability within the first postoperative week. However, an increased tendency to rotation after 1 w was observed, leading to a total of 19 (16.7%) IOLs rotating more than 5°, including one case exceeding 10° from EOS to 6 m. Refractive outcomes were favorable, with 92% of eyes achieving ≤0.50 D of residual refractive astigmatism.