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Cohort studyAmerican journal of translational research · 2026

Comparative study on rotational stability of toric intraocular lenses in cataract patients with low astigmatism: vertical versus horizontal implantation.

Hairong Che, Xinbo Jiao, Yun Wang, Xiaohui Qi

OphthalmologyCohort study

Vertical toric lens placement linked to lower odds of post-surgery lens rotation.

Comparative study on rotational stability of toric intraocular lenses in cataract patients with low astigmatism: vertical versus horizontal implantation.

Hairong Che … Xiaohui Qi

American journal of translational research · 2026

Purpose

To compare the effects of horizontal versus vertical in-the-bag implantation of toric intraocular lenses (intraocular lenses) on postoperative rotational stability, refractive outcome, and vision-related quality of life in cataract patients with low regular astigmatism, and to identify risk factors for postoperative rotational instability.

Methods

This retrospective study included 370 eyes of 370 patients with low regular astigmatism who underwent phacoemulsification with toric intraocular lenses implantation.

n = 370 eyes

Results

Vertical intraocular lens placement associated with lower odds of the lens rotating out of position.

OR 0.19 (95% CI 0.08 to 0.44)

null 1

0.08

0.44

CI excludes the null - significant

More results

Baseline and intraoperative data were comparable between groups.

The LMM revealed significant effects of time, group, and their interaction on rotation angle (all P < 0.001).

Rotation angles were significantly lower in the vertical implantation group than in the horizontal implantation group at all follow-up time points (all P < 0.001).

More results

The vertical group demonstrated better uncorrected visual acuity, BCVA, SE, and lower residual astigmatism (all P ≤ 0.001), along with higher NEI VFQ-25 scores across multiple domains.

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Conclusion

Vertical in-the-bag implantation of toric intraocular lenses provided superior rotational stability, refractive outcomes, visual recovery, and vision-related quality of life compared to horizontal implantation in cataract patients with low regular astigmatism.

Post

Comparative study on rotational stability of toric intraocular lenses in cataract patients with low astigmatism: vertical versus horizontal implantation.

Vertical toric lens placement linked to lower odds of post-surgery lens rotation.

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