Purpose To investigate the 1-year rotational stability of AcrySof Toric intraocular lenses (IOLs) and factors influencing their stability.

Methods This retrospective study enrolled 75 patients who underwent phacoemulsification, and were implanted with an AcrySof Toric IOL for 1 year. Their preoperative clinical data were reviewed. The 1-year clinical outcomes included uncorrected visual acuity, best-corrected visual acuity and residual astigmatism. Rotation of the IOL and the grade of anterior capsular opacification (ACO; graded from 0=none to 3=severe) were evaluated after mydriasis.

Results Of the 75 eyes analysed, 29.33% had high myopia. Residual astigmatism at 1 year (−0.76±0.47 dioptre(D)) was significantly reduced compared with the preoperative corneal astigmatism (2.08±0.71 D). The mean absolute rotation of the IOL was 8.83±5.26°. Toric IOL rotation was significantly and positively correlated with the degree of residual astigmatism in the T3 (Pearson's r=0.552, p<0.001) and T4 groups (Pearson's r=0.622, p=0.003). Regarding factors associated with IOL rotation, toric IOL rotation was positively correlated with axial length (AXL; Pearson's r=0.335, p=0.003) and negatively correlated with ACO grade (Spearman's r=−0.541, p<0.001). On multiple linear regression analysis, only AXL (B=0.889, p=0.031) and ACO grade (B=−3.216, p<0.001) were predictors of toric IOL rotation (R²=0.397).

Conclusions Long AXL is a risk factor for toric IOL rotation, while higher ACO grade may decrease toric IOL rotation, indicating that reducing the polishing of anterior capsule may improve the rotational stability of a toric IOL.

Trial registration number NCT02182921.