{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:47:19Z","timestamp":1760060839902,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cataract surgery often reveals preexisting corneal astigmatism, which can be corrected using a toric intraocular lens (T-IOL). However, postoperative T-IOL rotation may compromise correction. We investigated T-IOL rotation, focusing on deployment time and proximity to the posterior capsule (PC), using intraoperative optical coherence tomography (iOCT). Methods: Six different T-IOL models were inserted into acrylic simulated lens capsule models under different tacking durations (5 s, 30 s, and 60 s) and temperature conditions (23 \u00b0C, 28 \u00b0C, and 32 \u00b0C). The selection criteria for porcine lenses for examination required that they match human lens dimensions, typical of those used to train cataract surgeons. T-IOL misalignment due to vibration was assessed. Additionally, the impact of temporary intraocular pressure (IOP) reduction on T-IOL proximity to the PC was measured using iOCT in porcine eyes. Results: Tacking time and temperature independently affected T-IOL deployment, with shorter tacking durations and higher temperatures leading to faster deployment. Among lenses tested under identical tacking time and temperature conditions, iSert Micro Toric Aspheric 1-Piece IOL (355T3) had the slowest expansion time, while Avansee\u2122 Preload 1-Piece Toric (YP-T3) had the fastest. Porcine eyes with a corneal white-to-white major axis &lt; 16.0 mm fell within the 95% confidence interval for matching human lens size. Temporarily reducing IOP during surgery improved T-IOL adhesion to the PC, reducing both the occurrence and degree (from 14.0\u00b0 to nearly 0\u00b0) of postoperative rotation. Conclusions: Optimal T-IOL deployment, temporary IOP reduction during surgery, and enhanced adhesion to the PC can reduce the risk and degree of T-IOL rotation. Intraoperative iOCT aids in monitoring T-IOL positioning, which is essential to prevent rotation. Accumulated fluid between the T-IOL and PC may contribute to rotation, which requires further investigation. These findings provide practical strategies for enhancing T-IOL stability and improving the effectiveness of astigmatism correction in cataract surgery.<\/jats:p>","DOI":"10.3390\/jcm14186599","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T10:08:58Z","timestamp":1758276538000},"page":"6599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on Factors Affecting Toric Intraocular Lens Rotation Using Intraoperative OCT\u2014Factors Influencing IOL Deployment and Proximity to Posterior Capsule After Insertion"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6670-4283","authenticated-orcid":false,"given":"Kei","family":"Ichikawa","sequence":"first","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"},{"name":"General Aoyama Hospital, Toyokawa 441-0103, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Tokiwa","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-6662","authenticated-orcid":false,"given":"Yoshiki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Toda","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihito","family":"Kato","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Sakai","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6165-154X","authenticated-orcid":false,"given":"Kazuo","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-3204","authenticated-orcid":false,"given":"Naoki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Center for Society-Academia Collaboration, Research Promotion Headquarters, Fujita Health University, Toyoake 470-1192, Aichi, Japan"},{"name":"International Center for Cell and Gene Therapy, Research Promotion Headquarters, Fujita Health University, Toyoake 470-1192, Aichi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.jcrs.2010.02.025","article-title":"Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes","volume":"36","author":"Hoffmann","year":"2010","journal-title":"J. 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