Clinical Outcomes Using a Novel Image-Guided Planning System in Patients With Cataract and IOL Implantation

Abstract

To determine the proportion of eyes with preexisting astigmatism achieving 0.50 diopters (D) or less of residual refractive cylinder 3 months after either implantation of toric intraocular lenses (IOLs) or corneal incisions using the VERION system (Alcon Laboratories, Inc., Fort Worth, TX) measurement module and digital markers for microscope (M) and laser (L). Eyes with preexisting astigmatism in the intention-to-treat population were divided into four groups. Eyes in the no laser treatment group underwent toric IOL implantation with the measurement module, vision planner, and digital marker M (n = 102). Eyes in the other three groups underwent implantation of toric (n = 110), monofocal (n = 88), or multifocal (n =100) IOLs using the measurement module, vision planner, and digital marker M, including digital marker L, and LenSx laser (Alcon Laboratories, Inc.). The proportions of eyes achieving 0.50 D or less of relative refractive cylinder and with manifest refraction spherical equivalent (MRSE) deviating 0.50 D or less from the target outcome were evaluated at 3 months. The percentages of eyes achieving 0.50 D or less of relative refractive cylinder in the non-laser-treated, toric, monofocal, and multifocal groups at 3 months were 71.6%, 74.5%, 62.5%, and 71.0%, respectively. The percentages of eyes in these four groups with MRSE accuracies deviating 0.50 D or less from the target at 3 months were 69.6%, 80.0%, 77.3%, and 82.0%, respectively. The image-guided surgical planning system was effective in accurate correction of preexisting astigmatism in eyes undergoing refractive cataract surgery with IOL implantation, as shown by residual refractive astigmatism and MRSE at 3 months. [J Refract Surg. 2018;34(12):824-831.].