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

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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 languageEnglish
Pages (from-to)781-788
Number of pages8
JournalJournal of Cataract and Refractive Surgery
Volume43
Issue number6
DOIs
Publication statusPublished - Jun 2017

Keywords

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

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