Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

V.S.C. Webers; N.J.C. Bauer; N. Visser; T.T.J.M. Berendschot; F.J.H.M. van den Biggelaar; R.M.M.A. Nuijts

doi:10.1016/j.jcrs.2017.03.041

Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

V.S.C. Webers, N.J.C. Bauer, N. Visser, T.T.J.M. Berendschot, F.J.H.M. van den Biggelaar, R.M.M.A. Nuijts

Medical Image Analysis

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Abstract

Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. Results The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P =.02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was −0.36 ± 0.32 D and −0.47 ± 0.28 D in the image-guided group and manual group, respectively (P >.05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P >.05). No intraoperative complications occurred during any surgery. Conclusion The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.

Original language	English
Pages (from-to)	781-788
Number of pages	8
Journal	Journal of Cataract and Refractive Surgery
Volume	43
Issue number	6
DOIs	https://doi.org/10.1016/j.jcrs.2017.03.041
Publication status	Published - 1 Jun 2017
Event	34 Congress of the European Society of Cataract and Refractive Surgeonsescrs 2016 - Bella Center, Copenhagen, Denmark Duration: 10 Sept 2016 → 14 Sept 2016 http://escrs.org/Copenhagen2016/default.asp

Keywords

Astigmatism/surgery
Cataract Extraction
Humans
Lens Implantation, Intraocular/methods
Lens, Crystalline
Lenses, Intraocular
Visual Acuity

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10.1016/j.jcrs.2017.03.041

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title = "Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery",

abstract = "Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. Results The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P =.02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was −0.36 ± 0.32 D and −0.47 ± 0.28 D in the image-guided group and manual group, respectively (P >.05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P >.05). No intraoperative complications occurred during any surgery. Conclusion The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.",

keywords = "Astigmatism/surgery, Cataract Extraction, Humans, Lens Implantation, Intraocular/methods, Lens, Crystalline, Lenses, Intraocular, Visual Acuity",

author = "V.S.C. Webers and N.J.C. Bauer and N. Visser and T.T.J.M. Berendschot and {van den Biggelaar}, F.J.H.M. and R.M.M.A. Nuijts",

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doi = "10.1016/j.jcrs.2017.03.041",

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journal = "Journal of Cataract and Refractive Surgery",

issn = "0886-3350",

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note = "34 Congress of the European Society of Cataract and Refractive Surgeonsescrs 2016 ; Conference date: 10-09-2016 Through 14-09-2016",

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T1 - Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

AU - Webers, V.S.C.

AU - Bauer, N.J.C.

AU - Visser, N.

AU - Berendschot, T.T.J.M.

AU - van den Biggelaar, F.J.H.M.

AU - Nuijts, R.M.M.A.

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N2 - Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. Results The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P =.02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was −0.36 ± 0.32 D and −0.47 ± 0.28 D in the image-guided group and manual group, respectively (P >.05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P >.05). No intraoperative complications occurred during any surgery. Conclusion The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.

AB - Purpose To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. Setting University Eye Clinic Maastricht, Maastricht, the Netherlands. Design Prospective randomized clinical trial. Methods Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. Results The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P =.02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P <.05) postoperatively. The mean residual refractive cylinder was −0.36 ± 0.32 D and −0.47 ± 0.28 D in the image-guided group and manual group, respectively (P >.05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P >.05). No intraoperative complications occurred during any surgery. Conclusion The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.

KW - Astigmatism/surgery

KW - Cataract Extraction

KW - Humans

KW - Lens Implantation, Intraocular/methods

KW - Lens, Crystalline

KW - Lenses, Intraocular

KW - Visual Acuity

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JO - Journal of Cataract and Refractive Surgery

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T2 - 34 Congress of the European Society of Cataract and Refractive Surgeonsescrs 2016

Y2 - 10 September 2016 through 14 September 2016

ER -

Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery

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Keywords

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