To evaluate the effects of anterior capsulotomy extension on the rotational stability of four different types of intraocular lenses (IOLs) and to analyze factors influencing IOL rotation.

The present single-center prospective study was comprised of 128 cataract patients (151 eyes) who underwent cataract surgery and received AcrySof IQ SN60WF, Tecnis ZA9003, Akreos MI60, or Zeiss XL Stabi ZO from March 2010 to December 2010. Sixty-four eyes received an anterior capsulotomy extension which was unintentionally created or performed using Vannas scissors after capsulorrhexis to prevent anterior capsular contracture. After pupil dilation, a digital retroillumination image of the IOL was taken on the operative day and 7 days postoperatively.

There was no statistically significant difference in IOL rotation between the 4 types of IOL ( p > 0.05). The anterior capsulotomy extension group (2.72 ± 2.42°) and the non-extension group (3.24 ± 2.16°) did not show statistically significant differences in IOL rotation ( p > 0.05). A positive correlation was observed between age and IOL rotation. Axial length, anterior chamber depth, and anterior chamber volume did not affect the degree of rotation.

Among the 4 types of IOLs, there was no significant difference in rotational stability. Anterior capsulotomy extension to prevent anterior capsular contracture is not likely to significantly affect the rotational stability of IOLs; the 4 different types of IOL were stable in the eye and suitable as toric IOLs for correction of astigmatism.