June 2017

 

RESIDENTS

 

A randomized controlled trial of an image-guided system versus manual marking in the alignment of toric intraocular lenses in cataract surgery


by Valentijn S.C. Webers, MD, Noel J.C. Bauer, MD, PhD, Nienke Visser, MD, Tos T.J.M. Berendschot, PhD, Frank J.H.M. van den Biggelaar, PhD, Rudy M.M.A. Nuijts, MD, PhD

   

J Cataract Refract Surg. 2017;43(6). Article in press

Purpose: To compare the accuracy in toric IOL alignment using the VERION Image Guided System versus a conventional manual ink-marking procedure.
Setting: University Eye Clinic Maastricht, the Netherlands.
Design: Prospective randomized clinical trial.
Methods: A total of thirty-six eyes (24 patients) with regular corneal astigmatism of at least 1.25 diopters, which required cataract surgery and toric IOL implantation (AcrySof SN6AT3-T9), were randomly assigned to either the VERION group or the manual marking group. The primary outcome was the alignment of the toric IOL, by using pre- and postoperative images immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complication profile.
Results: The mean toric IOL misalignment was significantly less in the VERION group compared to the manual group both 1 hour (1.3 ± 1.6º vs. 2.8 ± 1.8º, p=.02) and 3 months postoperatively (1.7 ± 1.5º vs. 3.1 ± 2.1º, p<.05). The mean residual refractive cylinder was –0.36 ± 0.32 D and –0.47 ± 0.28 D for the VERION and manual group (p>.05), respectively. UDVA was 0.03 ± 0.10 logMAR in the VERION group versus 0.04 ± 0.09 logMAR in the manual group (both p>.05). No intraoperative complications occurred during any of the surgeries.
Conclusions: This study showed significantly less misalignment using digital marking when compared with manual marking. However, this did not result in a better UDVA or lower residual refractive astigmatism.

A randomized controlled trial of an image-guided system versus manual marking in the alignment of toric intraocular lenses in cataract surgery A randomized controlled trial of an image-guided system versus manual marking in the alignment of toric
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