Résultats réfractifs et évaluation de la précision du positionnement des implants toriques à l’aide d’un système d’alignement automatisé

Abstract

To compare precision in toric intraocular lens (TIOL) alignment and refractive outcomes between an intraoperative automated digital marker system and the conventional manual-ink marking. Prospective single center study including consecutive patients undergoing uneventful cataract surgery with corneal astigmatism greater than 1diopter. Total corneal astigmatism was measured using a placido-dual Scheimpflug system (GalileiG4®, Ziemer). Acrysof® SN6AT (Alcon) TIOL's were implanted, and patients were divided into 2groups, the digital group (Verion®, Alcon) and the ink-marking group (Pendular marker, AMO). Mean error in TIOL axis, visual acuity and residual astigmatism were analyzed at 3days, one month and 6months after surgery. In total, 45eyes of 30patients were included (n=25digital group, n=20ink-marking group). The mean preoperative total corneal astigmatism was 1.71±0.53diopters. At one month, there was a significantly lower mean average error in TIOL axis in the digital group compared to the ink-marking group (2.6±2.3° and 6.4±2.8° respectively, P=0.009). At 6months, these results remained statistically significant. Mean residual astigmatism was 0.7±0.4diopters at one month, without significant difference between the two groups (P=0.9). The rate of misalignment less than or equal to 5° was 86% (n=25) in the digital group and 63% (n=20) in the ink-marking group (P=0.05). Intraoperative digital marker system is associated with better TIOL alignment accuracy and better reproducibility than the manual ink-marking method.