Abstract
BackgroundAccurate alignment of toric intraocular lens (TIOL) to steep corneal astigmatic axis is important to achieve effective postoperative results. The authors compare the accuracy of astigmatism correction using automated and manual marking in TIOL implantation during cataract surgery.MethodsOne hundred thirty-two eyes with nuclear density from Grade 2 to 4 were randomly subdivided into 2 groups (automated and manual marking). All patients underwent manual marking and the steep axis was compared to SensoMotoric Instruments (SMI). After phacoemulsification, 62 patients underwent toric IOL implantation using the SMI and 70 patients underwent toric IOL implantation using manual marking. Intraoperative measurement was the steep axis difference. Clinical measurements included preoperative and postoperative best corrected visual acuity (BCVA), and TIOL axis.ResultsThe intraoperative steep axis difference between SMI and manual marking was 7.86 ± 6.4 degrees. The difference between the preoperative steep axis and the postoperative TIOL axis using SMI (3.63 ± 1.12 degrees) was significantly lower than that using manual marking (8.29 ± 2.23 degrees) (P < 0.05).ConclusionsThe steep axis measurements may be different when using SMI vs. manual marking. The SMI is more accurate than manual marking for TIOL implantation during cataract surgery.Trial registrationCurrent Controlled Trials ISRCTN12294725, Retrospectively registered, on 20 July 2018.
Highlights
Accurate alignment of toric intraocular lens (TIOL) to steep corneal astigmatic axis is important to achieve effective postoperative results
There were no statistically significant differences between the two groups according to age, preoperative mean astigmatism, and uncorrected and best corrected visual acuity (UCVA & BCVA) (P > 0.05)
The reference image and data of the steep axis were transferred to the SensoMotoric Instruments (SMI) system in the operating room
Summary
Accurate alignment of toric intraocular lens (TIOL) to steep corneal astigmatic axis is important to achieve effective postoperative results. The authors compare the accuracy of astigmatism correction using automated and manual marking in TIOL implantation during cataract surgery. Limbal corneal relaxing incisions and implantation of a toric intraocular lens (IOL) have been used for correction of astigmatism in cataract patients [3, 4]. Because 1° of off-axis rotation results in a loss of up to 3.3% of lens cylinder power [5], marking the accurate axis is most important for successful toric IOL implantation. An anterior segment photograph was used to identify several reference vessel points and axis marking points [7]. Digital overlay imaging was used to evaluate the alignment of toric IOL [8]
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