Associations between anterior segment parameters and rotational stability of a plate-haptic toric intraocular lens

Purpose: To evaluate the associations between anterior segment parameters and the rotational stability of a plate-haptic toric intraocular lens (IOL). Setting: Eye and Ear, Nose, Throat Hospital of Fudan University. Design: Retrospective case series. Methods: Patients who underwent uneventful phacoemulsification and plate-haptic toric IOL (AT TORBI 709M IOL) implantation were included. Preoperative axial length (AL) and anterior segment parameters, including the white-to-white (WTW) distance, anterior chamber depth (ACD), lens thickness (LT), and anterior segment length (ASL; the sum of ACD and LT) were recorded. IOL rotation, residual astigmatism (RAS), and visual acuity were evaluated 1 month postoperatively. The associations between the anterior segment parameters and IOL rotation were evaluated. Results: A total of 102 eyes of 102 patients were included. The mean AL was 26.43 ± 2.65 mm (range 21.71–34.60 mm). The mean IOL rotation was 4.59 ± 3.18 degrees, and RAS was 0.62 ± 0.39 D postoperatively. No correlation was detected between AL, ACD, or LT and the rotation of the plate-haptic toric IOL (all P > .05). However, its rotation correlated positively with the WTW distance ( r = 0.250, P = .011) and ASL ( r = 0.214, P = .030). Backward stepwise multiple linear regression revealed that the WTW distance (β = 2.142, P = .014) and ASL (β = 2.060, P = .037) were independent predictors of plate-haptic toric IOL rotation. Conclusions: Plate-haptic toric IOLs rotate more in eyes with larger WTW distances and longer ASLs; therefore, toric IOL implantation should be performed with caution in eyes with these characteristics.