Abstract:Correcting astigmatism safely and effectively has become a crucial part of modern cataract surgery due to the transformation of the surgery into a refractive procedure. The increased predictability and enhanced safety of Toric intraocular lens(IOL)implantation has made it the preferred method of correcting corneal regular astigmatism above 0.75D in cataract surgery. Toric IOL needs to be implanted in a precise axis position to achieve good astigmatism correction. A major cause of toric misalignment is postoperative rotation, which typically occurs soon after surgery. However, large axis misalignment will eliminate the astigmatism corrective effect of Toric IOL, even cause astigmatism in a new axis position. The factors responsible for IOL postoperative rotation are diverse. As a result, profound understanding of the factors is crucial for clinicians to minimize the rotation. Repositioning procedure is generally selected in case of significant rotation and the timing of the procedure is vital. This paper reviewed the influencing factors of IOL rotation postoperatively and its principle of treatment.