Early postoperative rotational behavior of a plate-haptic multifocal intraocular lens

Abstract Background Plate-haptic rotationally asymmetric multifocal toric intraocular lenses (IOLs) occasionally exhibit extensive postoperative misalignment. Therefore, this study aimed to evaluate postoperative rotational behavior by examining cases in which a nontoric plate-haptic multifocal intraocular lens (Lentis Comfort. LS-313 MF15, Oculentis GmbH; LC), sharing the same design as the toric model, was implanted intraoperatively in vertical, horizontal, or oblique orientations. Methods Patients who underwent uncomplicated phacoemulsification for age-related cataract with in-the-bag of LC were enrolled. Still images captured from surgical videos at the completion of surgery were superimposed on anterior segment images obtained under mydriasis at 3 or 4 days postoperatively, and the degree of intracapsular LC rotation was measured. Results A total of 202 eyes (202 patients) were included. Postoperative rotation ≥ 20° was observed in 17 eyes (8%), and extensive rotation ≥ 45° occurred in 9 eyes (4%). The intraoperative LC implantation orientation was vertical in 47 eyes (V group), horizontal in 52 eyes (H group), 45° oblique in 52 eyes (45° group), or 135° oblique in 51 eyes (135° group). No significant differences in mean postoperative rotation were observed among the four groups; however, the number of eyes with postoperative rotation ≥ 20° was 0 in the V group, 5 in the H group, 4 in the 45° group, and 8 un the 135° group. Conclusion Although mean postoperative rotation of LC did not differ significantly among implantation orientations, postoperative rotation ≥ 20° was observed when LC was implanted in horizontal or oblique orientations.