147798 20260217205611.0 doi 10.1371/journal.pone.0311566 sideral 141200 ART-2024-141200 eng Gargallo, Diana Universidad de Zaragoza The influence of rotational error and axial shift of toric intraocular lenses on residual astigmatism 2024 Access copy available to the general public Unrestricted Purpose Accurate alignment of Toric Intraocular Lens (T-IOLs) in cataract surgery is crucial for good visual outcomes. The purpose of this study was to evaluate the influence of rotation, axial shift and their combined effects on the refractive error and image quality of a wide range of T-IOL powers (from +1.50 D to +6.00 D cylinder) and two pupil diameters (3.34 and 4.44 mm). Methods Numerical ray tracing was utilized to quantify the residual error. Simulated retinal images and Visual Strehl (VS) ratios were calculated to evaluate image quality. Results First, T-IOL rotation showed better agreement with Holladay’s formula than 3.33% rule. Second, axial displacement resulted in acceptable residual cylinder (<0.50 D) across all examined cylinder powers. Third, concerning the combined effects, the influence of axial shift on residual cylinder becomes negligible when rotation errors exceed 2.5°. Fourth, a pupil-dependent nonlinear relationship was noted for image quality caused by both types of misalignment factors. Conclusions The 3.33% rule was confirmed as a reasonable approximation for the residual astigmatism caused by rotation of T-IOLs. The influence of axial shift on residual astigmatism becomes insignificant when there is also rotation. Image quality studies confirm that 30° of rotation are enough invalidate the compensation benefits of a T-IOLs in comparison with a Spherical Intraocular lens. info:eu-repo/grantAgreement/ES/DGA-FEDER/E44-23R info:eu-repo/grantAgreement/ES/MICIU/PID2020-114311RA-I00 info:eu-repo/semantics/openAccess by https://creativecommons.org/licenses/by/4.0/deed.es 2.6 2024 MULTIDISCIPLINARY SCIENCES 44 / 136 = 0.324 2024 Q2 T1 0.803 2024 Multidisciplinary 2024 Q1 5.4 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Remón, Laura Universidad de Zaragoza (orcid)0000-0002-3979-4528 Ares, Jorge Universidad de Zaragoza (orcid)0000-0002-1124-0363 Castro-Alonso, Francisco J. Universidad de Zaragoza 1013 646 Universidad de Zaragoza Dpto. Cirugía Área Oftalmología 2002 647 Universidad de Zaragoza Dpto. Física Aplicada Área Óptica 19, 12 (2024), e0311566 [18 pp.] PLoS One PLoS ONE 1932-6203 3642275 http://zaguan.unizar.es/record/147798/files/texto_completo.pdf Versión publicada 1940921 http://zaguan.unizar.es/record/147798/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:147798 articulos driver 2026-02-17-20:49:04 ARTICLE