Re-rotation of a Toric IOL

At our clinic, we routinely use the CASIA2 for preoperative evaluation of corneal astigmatism and subsequent planning of both toric and multifocal IOLs. Beyond its use in preoperative planning, it also provides valuable insights for the objective assessment of lens tilt and decentration before and after surgery. A 65-year-old female patient underwent uncomplicated cataract surgery and received a toric intraocular lens to correct her pre-existing corneal astigmatism. The IOL was aligned as planned at an implantation axis of 172°. 

At the follow-up examination one week after surgery, the patient had a residual astigmatism of -3.50 D. The axis of the toric IOL measured at the slit lamp was 130° instead of the planned implantation axis of 172°. A re-rotation of the IOL was performed on the same day without complications. The IOL then remained stable in the correct position.