Do three-piece PMMA IOLs rotate after implantation in the capsular bag?

Abstract

With the current interest in toric intraocular lenses (IOLs), it is critical to establish whether these implants rotate following cataract surgery. If there is continual rotation of the implant with capsular bag contraction, then the orientation of the astigmatic correction would be unstable and thus not clinically useful. Twenty-eight eyes were followed for up to 6 months postoperatively. These consecutive eyes were selected on the basis of demonstrating adequate dilation following surgery, such that the points of haptic to optic insertion could be visualized with the slit-lamp microscope. Sequential photographs and comparisons of the orientation of the lenses postoperatively were performed. With the exception of one lens implant, none of the 28 IOLs demonstrated significant rotation. Of the 16 eyes followed for 6 months, none demonstrated rotation of greater than 4 degrees, which was within experimental error. Continued rotation of PMMA IOLs following implantation in the capsular bag seldom occurs. Thus, the concept of toric IOLs appears to be quite usable.