Accuracy of toric intraocular lens implantation in cataract and refractive surgery
N. Visser, T.T.J.M. Berendschot, N.J. Bauer, J. Jurich, O. Kersting, R.M.M.A. Nuijts
MHeNs School for Mental Health and Neuroscience
PURPOSE: To determine the accuracy of a commonly used 3-step procedure for toric pseudophakic and phakic intraocular lens (IOL) implantation. SETTING: University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands. DESIGN: Cohort study. METHOD: In this analysis of toric IOL implantation, 6 preoperative images of the eye per patient and the surgery video were obtained using a digital imaging system. All 3 steps for toric IOL implantation were analyzed as follows: reference axis marking, alignment axis marking, and IOL alignment. In addition, vector analysis was used to calculate the errors in toric IOL alignment. RESULTS: Forty eyes (26 pseudophakic, 14 phakic) were analyzed. The mean errors in reference axis marking, alignment axis marking, and toric IOL alignment were 2.4 degrees +/- 0.8 (SD), 3.3 +/- 2.0 degrees, and 2.6 +/- 2.6 degrees, respectively. Together, these 3 errors led to a mean total error in toric IOL alignment of 4.9 +/- 2.1 degrees. Subgroup analysis showed no significant difference in mean error between pseudophakic IOL and phakic toric IOL alignment (P=.501). Vector analysis showed a mean angle or error of -2 +/- 8 degrees (pseudophakic IOLs) and 6 +/- 14 degrees (phakic IOLs). CONCLUSIONS: A commonly used 3-step ink-marker procedure to implant toric IOLs led to a mean error in IOL placement of approximately 5 degrees. The error was especially relevant in cases in which higher cylinder power IOLs were implanted. Orienting the toric IOL with great accuracy is necessary in all patients to achieve the best cylinder correction. FINANCIAL DISCLOSURE: Drs. Visser, Berendschot, Bauer, and Nuijts have no financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
Journal of Cataract and Refractive Surgery
https://doi.org/10.1016/j.jcrs.2011.02.024
ROTATIONAL STABILITY
CORNEAL ASTIGMATISM
CYCLOTORSION
INCISIONS
10.1016/j.jcrs.2011.02.024
Visser, N., Berendschot, T. T. J. M., Bauer, N. J., Jurich, J., Kersting, O., & Nuijts, R. M. M. A. (2011). Accuracy of toric intraocular lens implantation in cataract and refractive surgery. Journal of Cataract and Refractive Surgery, 37(8), 1394-1402. https://doi.org/10.1016/j.jcrs.2011.02.024
Visser, N. ; Berendschot, T.T.J.M. ; Bauer, N.J. ; Jurich, J. ; Kersting, O. ; Nuijts, R.M.M.A. / Accuracy of toric intraocular lens implantation in cataract and refractive surgery. In: Journal of Cataract and Refractive Surgery. 2011 ; Vol. 37, No. 8. pp. 1394-1402.
@article{5bcf4113730a4dc58a5a0959f35148b6,
title = "Accuracy of toric intraocular lens implantation in cataract and refractive surgery",
abstract = "PURPOSE: To determine the accuracy of a commonly used 3-step procedure for toric pseudophakic and phakic intraocular lens (IOL) implantation. SETTING: University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands. DESIGN: Cohort study. METHOD: In this analysis of toric IOL implantation, 6 preoperative images of the eye per patient and the surgery video were obtained using a digital imaging system. All 3 steps for toric IOL implantation were analyzed as follows: reference axis marking, alignment axis marking, and IOL alignment. In addition, vector analysis was used to calculate the errors in toric IOL alignment. RESULTS: Forty eyes (26 pseudophakic, 14 phakic) were analyzed. The mean errors in reference axis marking, alignment axis marking, and toric IOL alignment were 2.4 degrees +/- 0.8 (SD), 3.3 +/- 2.0 degrees, and 2.6 +/- 2.6 degrees, respectively. Together, these 3 errors led to a mean total error in toric IOL alignment of 4.9 +/- 2.1 degrees. Subgroup analysis showed no significant difference in mean error between pseudophakic IOL and phakic toric IOL alignment (P=.501). Vector analysis showed a mean angle or error of -2 +/- 8 degrees (pseudophakic IOLs) and 6 +/- 14 degrees (phakic IOLs). CONCLUSIONS: A commonly used 3-step ink-marker procedure to implant toric IOLs led to a mean error in IOL placement of approximately 5 degrees. The error was especially relevant in cases in which higher cylinder power IOLs were implanted. Orienting the toric IOL with great accuracy is necessary in all patients to achieve the best cylinder correction. FINANCIAL DISCLOSURE: Drs. Visser, Berendschot, Bauer, and Nuijts have no financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.",
keywords = "ROTATIONAL STABILITY, CORNEAL ASTIGMATISM, CYCLOTORSION, ORIENTATION, ALIGNMENT, INCISIONS, SYSTEM, MYOPIA",
author = "N. Visser and T.T.J.M. Berendschot and N.J. Bauer and J. Jurich and O. Kersting and R.M.M.A. Nuijts",
doi = "10.1016/j.jcrs.2011.02.024",
journal = "Journal of Cataract and Refractive Surgery",
publisher = "Elsevier Science",
Visser, N, Berendschot, TTJM, Bauer, NJ, Jurich, J, Kersting, O & Nuijts, RMMA 2011, 'Accuracy of toric intraocular lens implantation in cataract and refractive surgery', Journal of Cataract and Refractive Surgery, vol. 37, no. 8, pp. 1394-1402. https://doi.org/10.1016/j.jcrs.2011.02.024
Accuracy of toric intraocular lens implantation in cataract and refractive surgery. / Visser, N.; Berendschot, T.T.J.M.; Bauer, N.J.; Jurich, J.; Kersting, O.; Nuijts, R.M.M.A.
In: Journal of Cataract and Refractive Surgery, Vol. 37, No. 8, 08.2011, p. 1394-1402.
T1 - Accuracy of toric intraocular lens implantation in cataract and refractive surgery
AU - Visser, N.
AU - Berendschot, T.T.J.M.
AU - Bauer, N.J.
AU - Jurich, J.
AU - Kersting, O.
AU - Nuijts, R.M.M.A.
N2 - PURPOSE: To determine the accuracy of a commonly used 3-step procedure for toric pseudophakic and phakic intraocular lens (IOL) implantation. SETTING: University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands. DESIGN: Cohort study. METHOD: In this analysis of toric IOL implantation, 6 preoperative images of the eye per patient and the surgery video were obtained using a digital imaging system. All 3 steps for toric IOL implantation were analyzed as follows: reference axis marking, alignment axis marking, and IOL alignment. In addition, vector analysis was used to calculate the errors in toric IOL alignment. RESULTS: Forty eyes (26 pseudophakic, 14 phakic) were analyzed. The mean errors in reference axis marking, alignment axis marking, and toric IOL alignment were 2.4 degrees +/- 0.8 (SD), 3.3 +/- 2.0 degrees, and 2.6 +/- 2.6 degrees, respectively. Together, these 3 errors led to a mean total error in toric IOL alignment of 4.9 +/- 2.1 degrees. Subgroup analysis showed no significant difference in mean error between pseudophakic IOL and phakic toric IOL alignment (P=.501). Vector analysis showed a mean angle or error of -2 +/- 8 degrees (pseudophakic IOLs) and 6 +/- 14 degrees (phakic IOLs). CONCLUSIONS: A commonly used 3-step ink-marker procedure to implant toric IOLs led to a mean error in IOL placement of approximately 5 degrees. The error was especially relevant in cases in which higher cylinder power IOLs were implanted. Orienting the toric IOL with great accuracy is necessary in all patients to achieve the best cylinder correction. FINANCIAL DISCLOSURE: Drs. Visser, Berendschot, Bauer, and Nuijts have no financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
AB - PURPOSE: To determine the accuracy of a commonly used 3-step procedure for toric pseudophakic and phakic intraocular lens (IOL) implantation. SETTING: University Eye Clinic, Maastricht University Medical Centre, Maastricht, The Netherlands. DESIGN: Cohort study. METHOD: In this analysis of toric IOL implantation, 6 preoperative images of the eye per patient and the surgery video were obtained using a digital imaging system. All 3 steps for toric IOL implantation were analyzed as follows: reference axis marking, alignment axis marking, and IOL alignment. In addition, vector analysis was used to calculate the errors in toric IOL alignment. RESULTS: Forty eyes (26 pseudophakic, 14 phakic) were analyzed. The mean errors in reference axis marking, alignment axis marking, and toric IOL alignment were 2.4 degrees +/- 0.8 (SD), 3.3 +/- 2.0 degrees, and 2.6 +/- 2.6 degrees, respectively. Together, these 3 errors led to a mean total error in toric IOL alignment of 4.9 +/- 2.1 degrees. Subgroup analysis showed no significant difference in mean error between pseudophakic IOL and phakic toric IOL alignment (P=.501). Vector analysis showed a mean angle or error of -2 +/- 8 degrees (pseudophakic IOLs) and 6 +/- 14 degrees (phakic IOLs). CONCLUSIONS: A commonly used 3-step ink-marker procedure to implant toric IOLs led to a mean error in IOL placement of approximately 5 degrees. The error was especially relevant in cases in which higher cylinder power IOLs were implanted. Orienting the toric IOL with great accuracy is necessary in all patients to achieve the best cylinder correction. FINANCIAL DISCLOSURE: Drs. Visser, Berendschot, Bauer, and Nuijts have no financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
KW - ROTATIONAL STABILITY
KW - CORNEAL ASTIGMATISM
KW - CYCLOTORSION
KW - ORIENTATION
KW - ALIGNMENT
KW - INCISIONS
KW - SYSTEM
KW - MYOPIA
U2 - 10.1016/j.jcrs.2011.02.024
DO - 10.1016/j.jcrs.2011.02.024
JO - Journal of Cataract and Refractive Surgery
JF - Journal of Cataract and Refractive Surgery
Visser N, Berendschot TTJM, Bauer NJ, Jurich J, Kersting O, Nuijts RMMA. Accuracy of toric intraocular lens implantation in cataract and refractive surgery. Journal of Cataract and Refractive Surgery. 2011 Aug;37(8):1394-1402. https://doi.org/10.1016/j.jcrs.2011.02.024