Effect of Capsular Tension Ring Implantation on Postoperative Rotational Stability of a Toric Intraocular Lens

PURPOSE: To analyze clinical outcomes of cataract surgery with implantation of a toric intraocular lens (IOL) and to evaluate the effect of capsular tension ring (CTR) presence or absence on the rotational stability of implanted IOLs and postoperative refraction. METHODS: This cohort study included 64 eyes of 41 patients who underwent uneventful cataract surgery with implantation of a toric IOL (enVista toric MX60T; Bausch & Lomb, Rochester, NY) to correct preoperative corneal astigmatism. In 30 eyes, a CTR (11 SR model; Videris s.r.o., Prague, Czech Republic) was co-implanted. Analyzed parameters were refraction, visual acuity, and misalignment of toric lenses. RESULTS: The mean patient age was 67 years (range: 42 to 89 years) and the mean follow-up period was 5 months. Mean manifest astigmatism improved from −1.53 ± 1.15 diopters (D) preoperatively to −0.40 ± 0.61 D postoperatively ( P < .001). Postoperative uncorrected distance visual acuity was 0.10 ± 0.13 logMAR (20/25 Snellen). Mean absolute IOL misalignment was 3.70° with CTR and 3.85° without CTR ( P = .683). In eyes with an axial length of 24 mm or greater, IOL axis matched the planned axis in 90.5% of eyes with CTR and 81.8% of eyes without CTR ( P = .964). Four eyes (6.25%) needed additional surgical IOL rotation. CONCLUSIONS: In eyes after cataract surgery with implantation of a toric IOL, there were no significant differences in the rotational stability of the lens with respect to the presence or absence of CTR. In eyes with an axial length of 24 mm or greater, better IOL alignment was observed in the group with CTR. [ J Refract Surg . 2020;36(3):186–192.]