Rotational Stability and Refractive Outcomes of a Toric Hydrophilic Acrylic Intraocular Lens

PURPOSE: To assess rotational stability and refractive outcomes of a toric hydrophilic acrylic intraocular lens (IOL). DESIGN: Single-center, non-comparative, interventional clinical trial. METHODS: In this study 120 eyes from 80 patients with age-related cataract and preoperative corneal astigmatism greater than 1.0 diopter (D) were enrolled. Patients underwent phacoemulsification with implantation of a RayOne EMV Toric IOL. Rotational stability was evaluated relative to baseline measurements at the end of surgery (EOS) and compared to retroillumination images acquired at 1 hour (1h), 1 week (1w), 1 month (1m), and 6 months (6m), postoperatively. Subjective manifest refraction was assessed at the 6m follow-up visit. RESULTS: A total of 114 eyes from 75 patients were available for the final analysis. Mean absolute rotation from EOS to 6m was 2.44±2.34° [Range: 0.04;10.60]. Rotation between follow-up visits was 0.89±1.10° [0.00;8.37] from EOS to 1 h, 0.58±0.49° [0.00;2.76] from 1h to 1w, 1.19±1.45° [0.02;7.17] from 1w to 1m, and 1.11±1.41° [0.00;7.96] from 1m to 6m. Preoperative corneal astigmatism was 1.68±0.66D [1.00;3.99], which was reduced to a postoperative refractive astigmatism of 0.27±0.26D [0.00;1.25] at 6m. CONCLUSIONS: The RayOne EMV Toric IOL demonstrated good rotational stability within the first postoperative week. However, an increased tendency to rotation after 1 week was observed, leading to a total of 19 (16.7%) IOLs rotating more than 5°, including one case exceeding 10° from EOS to 6m. Refractive outcomes were favorable, with 92% of eyes achieving ≤0.50 D of residual refractive astigmatism.