Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

Valentijn S. C. Webers; Noel J. C. Bauer; Nienke Visser; Tos T. J. M. Berendschot; Frank J. H. M. van den Biggelaar; Rudy M. M. A. Nuijts

doi:10.1016/j.jcrs.2017.03.041

Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

Valentijn S. C. Webers^*, Noel J. C. Bauer, Nienke Visser, Tos T. J. M. Berendschot, Frank J. H. M. van den Biggelaar, Rudy M. M. A. Nuijts

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose: To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure.

Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands.

Design: Prospective randomized clinical trial.

Methods: Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications.

Results: The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees +/- 1.6 [SD] versus 2.8 +/- 1.8 degrees; P = .02) and 3 months (1.7 +/- 1.5 degrees versus 3.1 +/- 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was -0.36 +/- 0.32 D and -0.47 +/- 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 +/- 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 +/- 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery.

Conclusion: The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism. (C) 2017 ASCRS and ESCRS

Original language	English
Pages (from-to)	781-788
Number of pages	8
Journal	Journal of Cataract and Refractive Surgery
Volume	43
Issue number	6
DOIs	https://doi.org/10.1016/j.jcrs.2017.03.041
Publication status	Published - Jun 2017

Keywords

POSTERIOR CORNEAL ASTIGMATISM
CLINICAL-OUTCOMES
BILATERAL IMPLANTATION
ROTATIONAL STABILITY
REFRACTIVE OUTCOMES
UNITED-STATES
PREVALENCE
EYES
ACCURACY
ERROR

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Cite this

@article{d9c65a342c8043429de1b048d40ab8ea,

title = "Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery",

abstract = "Purpose: To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure.Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands.Design: Prospective randomized clinical trial.Methods: Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications.Results: The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees +/- 1.6 [SD] versus 2.8 +/- 1.8 degrees; P = .02) and 3 months (1.7 +/- 1.5 degrees versus 3.1 +/- 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was -0.36 +/- 0.32 D and -0.47 +/- 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 +/- 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 +/- 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery.Conclusion: The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism. (C) 2017 ASCRS and ESCRS",

keywords = "POSTERIOR CORNEAL ASTIGMATISM, CLINICAL-OUTCOMES, BILATERAL IMPLANTATION, ROTATIONAL STABILITY, REFRACTIVE OUTCOMES, UNITED-STATES, PREVALENCE, EYES, ACCURACY, ERROR",

author = "Webers, {Valentijn S. C.} and Bauer, {Noel J. C.} and Nienke Visser and Berendschot, {Tos T. J. M.} and {van den Biggelaar}, {Frank J. H. M.} and Nuijts, {Rudy M. M. A.}",

year = "2017",

month = jun,

doi = "10.1016/j.jcrs.2017.03.041",

language = "English",

volume = "43",

pages = "781--788",

journal = "Journal of Cataract and Refractive Surgery",

issn = "0886-3350",

publisher = "Elsevier Science",

number = "6",

}

TY - JOUR

T1 - Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

AU - Webers, Valentijn S. C.

AU - Bauer, Noel J. C.

AU - Visser, Nienke

AU - Berendschot, Tos T. J. M.

AU - van den Biggelaar, Frank J. H. M.

AU - Nuijts, Rudy M. M. A.

PY - 2017/6

Y1 - 2017/6

N2 - Purpose: To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure.Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands.Design: Prospective randomized clinical trial.Methods: Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications.Results: The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees +/- 1.6 [SD] versus 2.8 +/- 1.8 degrees; P = .02) and 3 months (1.7 +/- 1.5 degrees versus 3.1 +/- 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was -0.36 +/- 0.32 D and -0.47 +/- 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 +/- 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 +/- 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery.Conclusion: The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism. (C) 2017 ASCRS and ESCRS

AB - Purpose: To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure.Setting: University Eye Clinic Maastricht, Maastricht, the Netherlands.Design: Prospective randomized clinical trial.Methods: Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications.Results: The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees +/- 1.6 [SD] versus 2.8 +/- 1.8 degrees; P = .02) and 3 months (1.7 +/- 1.5 degrees versus 3.1 +/- 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was -0.36 +/- 0.32 D and -0.47 +/- 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 +/- 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 +/- 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery.Conclusion: The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism. (C) 2017 ASCRS and ESCRS

KW - POSTERIOR CORNEAL ASTIGMATISM

KW - CLINICAL-OUTCOMES

KW - BILATERAL IMPLANTATION

KW - ROTATIONAL STABILITY

KW - REFRACTIVE OUTCOMES

KW - UNITED-STATES

KW - PREVALENCE

KW - EYES

KW - ACCURACY

KW - ERROR

U2 - 10.1016/j.jcrs.2017.03.041

DO - 10.1016/j.jcrs.2017.03.041

M3 - Article

SN - 0886-3350

VL - 43

SP - 781

EP - 788

JO - Journal of Cataract and Refractive Surgery

JF - Journal of Cataract and Refractive Surgery

IS - 6

ER -