Postoperative Rotation of a 3-piece Loop-haptic Acrylic Intraocular Lens

Purpose: To assess the rotational stability of the AcrySof MA60BM acrylic intraocular lens (IOL) with and without aspiration of residual lens epithelial cells (LECs).

Setting: Stoke Mandeville Hospital, Aylesbury, United Kingdom.

Methods: Routine phacoemulsification was performed with (Group A) or without (Group B) aspiration of residual LECs (random allocation). The baseline position of the IOL was determined from a video frame acquired at the conclusion of surgery. Postoperative IOL position was documented using digital retroillumination images at 2 weeks and 3 months. Early IOL rotation (surgery to 2 weeks postoperatively) was graded as mild (<10 degrees), moderate (10 to 30 degrees), or severe (>30 degrees) by semiobjective comparison of the images. Late IOL rotation (2 weeks to 3 months) was measured more precisely using purpose-designed software.

Results: Group A had incomplete aspiration of residual LECs. The only between-group demographic difference was significantly more men in Group A than in Group B (P<.05). There were no cases of severe early IOL rotation. Mild and moderate early rotation occurred in 91.5% of eyes and 8.5% of eyes, respectively. The mean late rotation was 0.03 degrees +/- 3.06 (SD) (range 7.8 to -8.7 degrees). Aspiration of residual LECs made no statistical difference in early or late rotation (P>.05). Between 2 weeks and 3 months, counterclockwise rotation occurred in 50% of all cases.

Conclusions: Postoperative rotation of the loop-haptic IOL was stable; LEC clearance did not adversely affect performance. The tendency toward counterclockwise rotation would not preclude good performance of a toric model of the IOL.