Intraocular lens rotational stability after cataract surgery with and without primary posterior continuous curvilinear capsulorhexis

Purpose:To evaluate intraocular lens (IOL) rotational stability and capsular fusion process after cataract surgery with and without primary posterior continuous curvilinear capsulorhexis (PPCCC). Setting:Fujian Provincial Hospital, Fujian, China. Design:Prospective, intraindividual, randomized clinical trial. Methods:This study included 56 adult patients (112 eyes) with bilateral cataract undergoing phacoemulsification cataract surgery with PPCCC in 1 eye (PPCCC group) and conventional cataract surgery in the contralateral eye (NPCCC group). IOL axis orientation and fusion footprint length were measured at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively using OPD-Scan III, while the capsular bend index (CBI) was assessed at the same timepoints using Pentacam AXL. Results:No between-group difference was found in the absolute rotation from 1 day to 1 year (2.93 +/- 1.72 vs 2.66 +/- 1.61 degrees, P = .54). The absolute rotation from 1 week to 1 month in the NPCCC group was higher than that in the PPCCC group (1.65 +/- 0.68 vs 1.27 +/- 0.32 degrees, P = .01). At 1 month postoperatively, both fusion footprint length (9.11 +/- 2.74 vs 10.67 +/- 2.06 mm, P = .02) and CBI (2.92 +/- 0.60 vs 3.25 +/- 0.59, P = .03) were lower in the NPCCC group. Conclusions:Cataract surgery involving PPCCC demonstrated comparable outcomes with conventional procedures regarding long-term IOL rotational stability and therefore is a promising option for adult patients with cataract scheduled for toric IOL implantation. PPCCC slightly reduces IOL rotation in the early postoperative period, which can be attributed to accelerated capsular fusion.