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Automated FLACS marking of the CCC and individually engineered toric IOL for treatment of astigmatism

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First Author: L.Beckers GERMANY

Co Author(s):    D. Breyer   H. Kaymak   K. Klabe   M. Kirca   F. Kretz   G. Auffarth     

Abstract Details

Purpose:

Via novel laser capsulotomy patterns the implantation axis markings can now be incorparated as opposing tabs on the capsulotomy edge allowing for an accurate matching between IOL- and implantation axis. The aim of this retrospective analysis was to evaluate the intraoperative and the postoperative IOL-axis alignment.

Setting:

All surgeries were performed at the Breyer-Kaymak-Klabe Eye Surgery and Premium Eyes in Duesseldorf, Germany, member of the International Vision Correction Research Center (IVCRC.net).

Methods:

77 consecutive eyes with cataract surgery or refractive lens exchange via FLACS by LENSAR with automated iris registration using Cassini LED keratography (i-Optics) and toric IOL axis alignment by capsular marks using IntelliAxis-L (LENSAR) were included. Phacoemulsification and implantation of the toric IOL was performed. 75% of IOLs were individual toric Lentis LS-313 MF15, while the rest of toric IOLs were distributed among several other IOL models. After surgery and 3 months postoperatively the eye was photographed such that intraoperative misalignment and postoperative rotation could be determined. We also measured the preoperative corneal cylinder and the postoperative subjective refraction.

Results:

The intraoperative alignment error was 0.83°+-0.86°, which is roughly half as much as the recently reported literature-value 1.87°+-2.11° using the manual marking technique (Inoue Y et al. Axis Misalignment of Toric Intraocular Lens: Placement Error and Postoperative Rotation. Ophthalmology. 2017 Sep;124(9):1424-25). The postoperative rotation was 0.53°+-5.01°. The postoperative corneal cylinder was in comparison to preoperative cylinder reduced (-1.42 ± 1,29 D vs. -0.33 ± 0.37 D). The subjective refraction was reduced after 3 month of surgery (-0.42 ± 3.69 D vs. -0.24 ± 0.85 D).

Conclusions:

From our data analysis we see a further reduction in intraoperative misalignment of toric IOLs by using femtosecond laser-assisted automated caspular marks. Data transfer, workflow and prevention of read-off errors is system inherently better with IntelliAxis-L. Therefore IntelliAxis-L is our new standard of care for the implantation of toric IOL.

Financial Disclosure:

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