Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr 24:12:747-753.
doi: 10.2147/OPTH.S164175. eCollection 2018.

Comparative evaluation of toric intraocular lens alignment and visual quality with image-guided surgery and conventional three-step manual marking

Jeewan S Titiyal  1 , Manpreet Kaur  1 , Cijin P Jose  1 , Ruchita Falera  1 , Ashutosh Kinkar  1 , Lalit Ms Bageshwar  1
Affiliations

Comparative evaluation of toric intraocular lens alignment and visual quality with image-guided surgery and conventional three-step manual marking

Jeewan S Titiyal et al. Clin Ophthalmol. .

Abstract

Purpose: To compare toric intraocular lens (IOL) alignment assisted by image-guided surgery or manual marking methods and its impact on visual quality.

Patients and methods: This prospective comparative study enrolled 80 eyes with cataract and astigmatism ≥1.5 D to undergo phacoemulsification with toric IOL alignment by manual marking method using bubble marker (group I, n=40) or Callisto eye and Z align (group II, n=40). Postoperatively, accuracy of alignment and visual quality was assessed with a ray tracing aberrometer. Primary outcome measure was deviation from the target axis of implantation. Secondary outcome measures were visual quality and acuity. Follow-up was performed on postoperative days (PODs) 1 and 30.

Results: Deviation from the target axis of implantation was significantly less in group II on PODs 1 and 30 (group I: 5.5°±3.3°, group II: 3.6°±2.6°; p=0.005). Postoperative refractive cylinder was -0.89±0.35 D in group I and -0.64±0.36 D in group II (p=0.003). Visual acuity was comparable between both the groups. Visual quality measured in terms of Strehl ratio (p<0.05) and modulation transfer function (MTF) (p<0.05) was significantly better in the image-guided surgery group. Significant negative correlation was observed between deviation from target axis and visual quality parameters (Strehl ratio and MTF) (p<0.05).

Conclusion: Image-guided surgery allows precise alignment of toric IOL without need for reference marking. It is associated with superior visual quality which correlates with the precision of IOL alignment.

Keywords: Callisto eye and Z align toric IOL; image-guided surgery; manual marking toric IOL; toric IOL alignment; visual quality image-guided surgery; visual quality toric IOL.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Postoperative assessment of toric IOL alignment with ray tracing aberrometer in a case in group I (conventional manual marking). A 6° deviation from target axis of implantation is present. Abbreviation: IOL, intraocular lens.
Figure 2
Figure 2
Postoperative assessment of toric IOL alignment with ray tracing aberrometer in a case in group II (image-guided surgery). A 1° deviation from target axis of implantation is present. Abbreviation: IOL, intraocular lens.
See this image and copyright information in PMC

References

    1. Hoffmann PC, Hütz WW. Analysis of biometry and prevalence data for corneal astigmatism in 23,239 eyes. J Cataract Refract Surg. 2010;36:1479–1485. - PubMed
    1. Ferrer-Blasco T, Montés-Micó R, Peixoto-de-Matos SC, González-Méijome JM, Cerviño A. Prevalence of corneal astigmatism before cataract surgery. J Cataract Refract Surg. 2009;35:70–75. - PubMed
    1. Collier Wakefield O, Annoh R, Nanavaty MA. Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery. Eye (Lond) 2016;30:562–569. - PMC - PubMed
    1. Shimizu K, Misawa A, Suzuki Y. Toric intraocular lenses: correcting astigmatism while controlling axis shift. J Cataract Refract Surg. 1994;20:523–526. - PubMed
    1. Felipe A, Artigas JM, Díez-Ajenjo A, García-Domene C, Alcocer P. Residual astigmatism produced by toric intraocular lens rotation. J Cataract Refract Surg. 2011;37:1895–1901. - PubMed

LinkOut - more resources