This prospective comparative cohort study evaluates and compares postoperative rotational stability and time-course dynamics of three commercially available toric intraocular lenses (TECNIS Toric II [ZCU], AcrySof IQ Toric, and AT TORBI 709M) after phacoemulsification cataract surgery. Rotation is quantified by registering postoperative retroillumination photographs to the end-of-surgery baseline using iris/scleral landmarks, with follow-up at postoperative day 1, day 3, week 1, week 2, month 1, and month 3. Associations between rotational outcomes and ocular biometric parameters are analyzed using linear mixed-effects models to inform individualized IOL selection and perioperative management.

Inclusion Criteria:

• Adults aged 18 years or older with age-related cataract scheduled for phacoemulsification cataract surgery.
• Presence of regular corneal astigmatism requiring toric intraocular lens implantation.
• Eligible for implantation of one of the three study toric intraocular lenses based on preoperative evaluation.
• Ability to understand the study procedures and provide written informed consent.

Exclusion Criteria:

• History of prior ocular surgery in the study eye.
• History of ocular trauma in the study eye.
• Irregular corneal astigmatism or corneal pathology affecting reliable biometric measurement.
• Intraoperative complications, including anterior capsular tear or posterior capsular rupture.
• Inadequate pupillary dilation during surgery or postoperative examinations.
• Evidence of zonular weakness, zonular dialysis, or lens subluxation.
• Active ocular infection or inflammation.
• Any other ocular or systemic condition judged by the investigator to potentially affect intraocular lens stability or study outcomes.

Outcome assessors were masked to IOL type.