Analysis of factors associated with rotational stability of toric intraocular lens after high axial myopia cataract surgery

Abstract

Abstract Background: To observe the rotational stability (RS) of toric intraocular lens (TIOL) in patients with high axial myopia cataract and to analyse the factors associated with it. Methods: This study was approved by a certified local review board (Registered: 2023-387-01, Date: 2023.01.04) and enrolled 60 cataract patients after TIOL implantation in GuangZhou Red Cross Hospital of Jinan University from January 2023 to June 2023, of which 30 patients in group A were diagnosed high axial myopia (Axial Length, AL ≥ 26 mm) and 30 patients in group B were normal AL (22 mm <AL < 26 mm), and the data of were collected and analysed at least half a year after surgery. To analyse the RS of TIOL and the correlation between RS and AL, TIOL material, White-To-White (WTW) and IOL power. Results: The difference in rotation angle (RA) between group A and B was statistically significant (RAA group = 16.03 ± 21.47, RAB group = 5.60 ± 8.27, p = 0.013 < 0.05); the difference in clinically significant rotation (CSR) between group A and group B was statistically significant (CSRA group = 17, CSRB group = 7, P = 0. 008 < 0.05), postoperative RA and CSR were positively correlated with the AL (pRA = 0.010, rRA = 0.332; pCSR = 0.008, rCSR = 0.342); and there was significantly more CSR of hydrophilic lens in group A than hydrophilic lens in group B (CSRHydrophilic-A group = 10 ＞ CSRHydrophilic-B group = 3, p = 0.01 < 0.05). There was a strong correlation between CSR and AL (p = 0.002, r = 0.720); more patients rotated counterclockwise than clockwise after TIOL and the difference was statistically significant (P = 0.004 < 0.05), and significantly more patients with hydrophobic lens rotated counterclockwise ( P= 0.035 < 0.05). Conclusions: The longer the AL of the eye, the more likely the toric lens will rotate post-operatively and the greater the RA; the toric lens tends to rotate counterclockwise, which is more pronounced in hydrophobic IOLs; hydrophilic toric lenses tend to rotate in patients with high axial myopia and the longer the AL, the greater the likelihood of rotation.