The posterior optic capture as a way to increase the rotational stability of toric intraocular lenses

Background. Implantation of toric IOLs allows to achieve the best visual results in patients with astigmatism. However, even a small dislocation of the toric IOL can significantly reduce the effectiveness of correction. Dislocation is eliminated by repositioning the IOL, which, although minimal, is a repeated surgical intervention. In addition, in clinical practice, there are cases when toric lenses retain their rotational instability even after repositioning and may require repeated intervention. In modern surgical practice, there are various ways to prevent toric IOL rotation. The most popular method is the implantation of capsular rings (CR) of various models, which should increase the stability of IOL in patients with a large axial length of the eye, but the effectiveness against other factors of IOL dislocation in CR is low and cannot completely eliminate the risk of lens displacement.

The aim. Demonstration of clinical cases of rotational instability of toric IOLs and methods of its prevention and relief by the method of posterior optic capture.

Material and methods. Clinical cases of rotational instability of toric IOLs are presented on the example of patients with capsulorexis of excessive diameter and rotation in the late postoperative period. The patients underwent cataract phacoemulsification with implantation of a toric intraocular lens with the implementation of a posterior capture of toric IOL optics.

Results. The postoperative period was calm against the background of standard therapy. The period of postoperative follow-up was 2–3 months. Both patients had high and stable visual acuity from 0.7 to 1.0 after surgery. The thiols maintained a centered position and were positioned in accordance with the calculated axis, which was confirmed by the OCT data of the anterior segment. The optical zone was transparent in both cases, and there were no signs of Ellingson’s syndrome and iris transillumination.

Conclusion. The method of posterior optic capture of IOL makes it possible to effectively and safely solve the problem of rotational instability of toric IOL.

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