Rotational Stability of Three Toric Intraocular Lens Platforms After Cataract Surgery: A Prospective Multicenter Randomized Trial
In brief
Hydrophobic C-loop toric lens keeps >10° rotation under 2% versus 12% with plate-haptic
In a randomized trial of 256 eyes, the hydrophobic C-loop toric IOL showed the smallest postoperative rotation, with only about 1% of eyes rotating 10 degrees or more, compared with 12% for the hydrophilic plate-haptic lens. Early stability was reached by one week for the C-loop lenses, suggesting platform-specific selection and monitoring may improve refractive outcomes.
- Journal
- Journal of cataract and refractive surgery (Q1)
- Published
- 15 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Xuanqiao Lin, Xiaohuan Zhao, Yanhong Hou, Wenqian Shen, Baoxian Zhuo, Lifang Bai, et al.
- PMID
- 42460451
- DOI
- 10.1097/j.jcrs.0000000000002023
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 19 July 2026): Rotational stability comparison of three toric IOL platforms
Abstract
PURPOSE: To compare the postoperative rotational stability of three toric intraocular lens (IOL) platforms and identify platform-specific biometric factors associated with rotation. SETTING: Three eye centers in China. DESIGN: Prospective multicenter randomized controlled trial. METHODS: A total of 256 eyes of 172 cataract patients with regular corneal astigmatism that completed 3 months of follow-up after phacoemulsification with implantation of TECNIS Toric II, Clareon Toric, or AT TORBI 709M were included. Participants were randomly assigned to 1 of the 3 toric IOL platforms. Baseline rotational alignment was defined at the end of surgery and compared with retroillumination images obtained at 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months postoperatively. RESULTS: Absolute rotation changed most prominently within the first week and then progressively stabilized. Rotational stability was reached earlier in the ZCU and CNW0T groups, which plateaued at 1 week, whereas the 709 approached stability between 2 weeks and 1 month. Throughout follow-up, the 709 showed greater rotation than the CNW0T, whereas the ZCU demonstrated the least rotation. Significant rotation of ≥10° occurred in 1.2%, 2.4%, and 12.2% of eyes, respectively. White-to-white distance was associated with greater rotation in the CNW0T and 709 groups, lens thickness was additionally associated with greater rotation in the 709 group, and no biometric factor reached significance in the ZCU group. CONCLUSIONS: Hydrophobic C-loop toric IOLs showed better early rotational stability than the hydrophilic plate-haptic toric IOL. Biometric correlates of rotation differed across platforms, supporting individualized toric IOL selection and postoperative monitoring.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.