The authors evaluate 50 eyes of 28 patients that underwent an angle fixated phakic intraocular lens (IOL) implantation (Acrysof Cachet). All eyes had moderate to high myopia (-5.25 to-19.63 dioptres) and IOL sizing was performed as per the manufacturer’s recommendation. All eyes had digital photography to assess IOL position at 0 and 12 months postoperatively. There were no intraoperative complications. Only one eye required additional laser refractive correction. A mean IOL rotation of 11.4±15.1 (range 0 to 60) was noted at 12 months compared to the initial assessment at 0 months. IOL rotation was not associated with endothelial cell loss (which remained stable after three months postoperatively). This study s
hows a larger rotation than previously reported in other studies and the authors suggest that this may be due to less effective methods of rotational stability assessment by others. The authors stipulate that rotation may be related to pupil movement and accommodation and also suggest that ultrasound biomicroscopy may be useful in assessing eyes with greater IOL rotation. They conclude that this design of the cachet lens would not be suitable for toric correction due to its higher rotational instability.