The risk factors for postoperative rotation in the early post-operative period; a longer axial length, younger patients, and with the rule astigmatism as described by Miyake T et al. (JCRS 2014) in a case series of six eyes. This letter adds that a capsulorrhexis, larger than the size of the optic is an additional risk factor for post-operative rotation. The authors of the letter identify that in four out of six of Miyake’s cases the capsulorrhexis was larger than the size of the optic. Miyake responds that a large capsulorrhexis is a risk factor for late postoperative rotation. The ideal capsulorrhexis is 0.5mm smaller than the optic diameter. The anterior and posterior capsule fuse with the intraocular lens (IOL) minimising postoperative rotation. Fibronectin plays a major role in IOL-capsular bag adhesion.
Toric intraocular lens rotation related to the capsulorrhexis
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