![]() ![]() The study conforms to the tenets of the Declaration of Helsinki.Įighty patients (80 eyes) with cataract and astigmatism ≥1.5 D scheduled to undergo phacoemulsification with toric IOL implantation were enrolled in the study. Written informed consent was obtained from all patients. Ethical clearance was obtained from the institutional review board (AIIMS, New Delhi). The prospective comparative study was conducted at Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. #Itrace abberometer manual#We herein compared the toric IOL alignment assisted by Callisto eye and Z align (Carl Zeiss Meditec AG, Jena, Germany) and manual axis marking using the bubble marker (Nuijts Lane Toric Reference Marker), and its impact on visual quality. 7– 9 No study has evaluated the effect of toric IOL alignment on visual quality with different marking methods. 7– 10 A superior alignment of the toric IOL has been demonstrated with the image-guided systems as compared to conventional manual marking methods however, the visual outcomes are comparable. Several image-guided modalities have been developed for precise toric IOL alignment that obviate the need for preoperative axis marking and aim to decrease the subjectivity associated with manual marking. 6 However, the subjective nature of this procedure can lead to inaccurate marking in inexperienced hands and result in a suboptimal visual outcome. 4, 5Ī three-step procedure has conventionally been used for axis marking on the cornea and helps in alignment of the IOL within 5° of the intended axis. One degree of misalignment reduces the astigmatic correction by ~3.3%, with more than 30° misalignment effectively increasing the amount of preoperative astigmatism. 1– 3 Accurate toric IOL alignment along the desired corneal meridian is a prerequisite for achieving an optimal visual outcome. Keywords: toric IOL alignment, image-guided surgery, manual marking toric IOL, Callisto eye and Z align toric IOL, visual quality toric IOL, visual quality image-guided surgeryĬorneal astigmatism of 1 D or more may be present in more than one-third of the patients undergoing cataract surgery, and toric intraocular lenses (IOLs) are a safe and effective modality in such cases to help achieve emmetropia. It is associated with superior visual quality which correlates with the precision of IOL alignment. Significant negative correlation was observed between deviation from target axis and visual quality parameters (Strehl ratio and MTF) ( p<0.05).Ĭonclusion: Image-guided surgery allows precise alignment of toric IOL without need for reference marking. 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. Visual acuity was comparable between both the groups. Postoperative refractive cylinder was -0.89☐.35 D in group I and -0.64☐.36 D in group II ( p=0.003). Results: Deviation from the target axis of implantation was significantly less in group II on PODs 1 and 30 (group I: 5.5°☓.3°, group II: 3.6°☒.6° p=0.005). Follow-up was performed on postoperative days (PODs) 1 and 30. Secondary outcome measures were visual quality and acuity. ![]() Primary outcome measure was deviation from the target axis of implantation. Postoperatively, accuracy of alignment and visual quality was assessed with a ray tracing aberrometer. 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). Purpose: To compare toric intraocular lens (IOL) alignment assisted by image-guided surgery or manual marking methods and its impact on visual quality. Jeewan S Titiyal, Manpreet Kaur, Cijin P Jose, Ruchita Falera, Ashutosh Kinkar, Lalit MS BageshwarĬornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India ![]()
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