The role of Verion™ guiding system in cataract surgery refractive outcomes with the implantation of an AcrySof IQ toric lens

Session Details

Session Title: Cataract Surgery/ Equip/ IOLs

Session Date/Time: Sunday 14/09/2014 | 14:30-16:00

Paper Time: 15:21

Venue: Capital Hall B

First Author: : I.Iliescu ROMANIA

Co Author(s): :    O. Moraru              

Abstract Details

Purpose:

The VerionTM Guiding System is designed as a guidance and planning suite for cataract surgery in order to decrease variables and to provide more consistecy in our refractive surgical results. Our paper evaluates the clinical outcomes after a Verion assisted implantation of an Acrysof IQ Toric lens in patients with significant corneal astigmatism having routine cataract surgery.

Setting:

Oculus Eye Clinic – Bucharest – Romania

Methods:

In this prospective study we included 30 eyes of 24 patients operated for cataract with the implantation of an Acrysof IQ Toric lens. Preoperative corneal astigmatism measurements and IOL Toric power calculation were made in two ways. First we measured corneal astigmatism with the Autokeratometer Topcon KR 8900 and then we input the data in the online Alcon Toric Calculator. Second, we measured corneal astigmatism using Verion Reference Unit and we calculated the IOL Toric Power using the Verion Planner. All patients had their ocular axial length measured using the IOL Master and the OcuScan. After Verion guided cataract surgery, an Acrysof IQ Toric lens was implanted in the capsular bag. The toric lens was chosen from the Verion measurements (to be able to compare them with the ’old’ measurement and calculation method – Autokeratometry and online Acrysof ToricCalculator). Postoperative distance UCVA, BCVA, objective and manifest refraction, residual refractive cylinder, spectacle independence and IOL axis alignment were measured at 1 and 3 months. We also compared the two corneal power measurements, the two predicted IOL Toric powers and the two residual refractive cylinder for each case to be able to evaluate the acuracy of the two methods of K measurements.

Results:

The study enrolled 30 eyes of 24 patients. All eyes had the 1 month evaluation and 9 eyes also reached their 3 months follow-up. Preoperative corneal astigmatism ranged from 0.5(against the rule) to 3.51D and the refractive cylinder ranged from 1D-5.25D. The mean refractive cylinder reduction at 1 month follow up was approximately 80% with a mean absolute post-operative residual refractive cylinder of 0.44D (SD 0.56D). Mean UCDVA was 0,6 (but 8 eyes had preop high miopia and were targeted to -2.5D), mean BCDVA was 0.89. Mean absolute IOL rotation from surgery was 1.96 degrees with rotation less than 5° in 93% of the eyes. Comparing the refractive results we obtained implanting the IOL Toric power sugested by Verion with the presumptive ones sugested by online IOL Toric Calculator, we concluded that in 18 cases (60%) the K measurements were similar between the two methods, this leading to similar results in terms of IOL spherical power, toricity power and toric axis alignment, in 10 cases (33%) the Verion K measurements were superior and in 2 cases (~7%) the ’old’ method of calculation, with Autokeratometry would have been more acurate.

Conclusions:

Implantation of the Acrysof IQ Toric lens using the Verion Guidance System is a safe and effective method to correct corneal astigmatism in patients having routine cataract surgery. The Verion System makes the toric implantation easier, without the need of the preoperative or intraoperative corneal marking of the cylinder axis. Moreover, using this System, the IOL Toric alignment at the end of cataract surgery is more precise and the refractive predictability enhanced.

Financial Interest:

NONE