Abstract：Objective: To compare the rotation stability of horizontal, oblique, vertical implantable collamer lens (ICL) implantation and horizontal Toric ICL (TICL) implantation at 1 month and 1 year after operation. Methods: This was a retrospective clinical study. One hundred and eighty-four eyes of 92 consecutive patients with refractive errors who underwent ICL (V4c) implantation in the refractive surgery department of Zhengzhou Aier Eye Hospital from January 2020 to June 2021 were collected, composed of 59 eyes in horizontal ICL group, 33 eyes in oblique ICL group, 36 eyes in vertical ICL group, and 56 eyes in horizontal TICL group according to the axial orientation of the lens on the frst day after the operation.Uncorrected visual acuity, intraocular pressure, vault, and lens axial direction were recorded at 1 day, 1 month, and 1 year after operation, and the effectiveness index, lens rotation angle, and lens rotation direction were further calculated. Analysis of variance of repeated measures was used for the data analysis. Kruskal-Wallis test was used to compare lens rotation angles among groups. Pearson Chi-square test was used to compare lens rotation direction among groups. Spearman rank correlation analysis and multiple linear regression analysis were used to explore the correlation of age, gender, and other indicators with the lens rotation angle at 1 year after operation. Results: There were no signifcant differences in the effectiveness index, intraocular pressure, vault, and endothelial cell density among horizontal ICL group, oblique ICL group, vertical ICL group, and horizontal TICL group at 1 month and 1 year after operation (all P>0.05). There were no signifcant differences in lens rotation angles among the four groups at 1 month and 1 year after operation (H=6.36, P=0.095; H=4.82, P=0.185). There were no signifcant differences in lens rotation direction among the four groups at 1 month and 1 year after operation (χ2=4.44, P=0.617; χ2=6.03, P=0.420). There had no correlations of age, gender, and other indicators with lens rotation angle at 1 year after operation (all P>0.05). Conclusion: Horizontal ICL, oblique, vertical implantation, and horizontal TICL implantation can achieve relatively consistent postoperative outcomes and rotational stability at 1 month and 1 year after operation.
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