Accuracy in toric intraocular lens alignment using a perioperative automated digital marker system

Session Details

Session Title: Pseudophakic IOLs: Toric I

Session Date/Time: Saturday 10/09/2016 | 16:00-18:00

Paper Time: 17:24

Venue: Hall C2

First Author: : C.Schweitzer FRANCE

Co Author(s): :    L. Tellouck   J. Tellouck   C. Costet   D. Touboul   T. Cornut        

Abstract Details

Purpose:

To analyze the accuracy in toric intraocular lens (IOL) alignment and refractive outcomes using an intraoperative automated digital marker system.

Setting:

University hospital of Bordeaux (France)

Methods:

Prospective monocenter study including consecutive patients undergoing an uneventful cataract surgery with a toric IOL (Acrysof, Alcon, Fortworth, USA) implanted in the capsular bag and having a corneal astigmatism superior to 1 diopter. Each patient underwent a measurement of total corneal astigmatism using a placido-dual Scheimpflug system (GalileiG4®, Ziemer, Switzerland) and an evaluation of limbal vessels using Verion system® (Alcon, Fortworth, USA). Digital marking procedure was performed using Verion system integrated in the surgical microscope. Uncorrected and best-corrected visual acuity, average error in toric IOL axis using Placido-Dual Scheimpflug Galilei® were analyzed at 3 days and one month after surgery.

Results:

30 eyes of 20 patients were included, the mean age was 66.7±8.5 years. Mean preoperative total corneal power astigmatism was 1.74±0.73 diopters. Mean average error in toric IOL axis was 2.72±1.27 degrees at day 3 and 2.93±2.54 degrees at one month. At one month, mean uncorrected visual acuity was 0.14±0.25 LogMAR and mean best-corrected visual acuity was -0.001±0.05 LogMAR. The automatic recognition of limbal vessels by the digital marker system was complete for all surgical procedures and no intraoperative or postoperative complications were recorded. A comparison with a manual ink-marking group will be also provided.

Conclusions:

Toric IOLs provide very good anatomical and refractive outcomes but a small misalignment can induce a decrease in toric IOL performance to treat astigmatism. In a consecutive case series, our study shows a very accurate positioning of toric IOL from the intended axis leading to an average error inferior to 5 degrees. By taking into account cyclotorsion and by tracking the eye during the surgical procedure, automated digital marker systems may help clinicians to improve refractive outcomes of astigmatic patients. Comparative studies with a manual ink-marking procedure are required to quantify the clinical benefit for patients of a such innovation.

Financial Disclosure:

NONE