Comparison between using INTEGRA and manual method in determining axis for intraocular lens implantation

Abstract

The aim of this study was to explore the efficacy, repeatability, and efficiency of a new intraoperative contactless device (INTEGRA Optomed, Chorzów, Poland) for determining the axis for toric intraocular lens implantation and then to compare this with that determined using a manual method. This study was conducted at the Ophthalmological Center for Children and Adults Optomed, Chorzów, Poland. This nonrandomized, retrospective, observational study included 20 eyes of 12 patients (5 males and 7 females) who had toric intraocular lens implanted. A video recording of each surgery using the INTEGRA system was made showing the analysis. The surgeon and one of the researchers then independently assessed the location of the implant axes determined with both digital and manual slit-lamp methods, and compared them. The implantation axes suggested for both the manual and INTEGRA methods were similar. The median axis disparities were 0.0 degree and 0.5 degree, and standard deviations were 0.61 and 0.81 for researcher 1 and 2, respectively. The dominant value was 0.0 in both groups. The INTEGRA axis designation was not statistically different from the manual method (level of significance: α < 0.01). The INTEGRA system is a digital ink-free device for image tracking scleral vessels. It was helpful for determining the implantation axis in a precise and repeatable manner, and measurements were comparable with a manual technique.

Clinical outcomes, predictability and rotational stability following implantation of Eyecryl toric versus TECNIS toric intraocular lenses—A comparative study

“…As shown in various studies, the post-operative rotation of toric IOLs is observed more often in early post-operative period, and even as early as 1 h after the surgery. [12,13,15] However, no significant differences in rotational stability were noted after 1-week. This is why we performed rotational stability evaluation at 1-week post-op, as toric IOL position usually settles by this time and rotations, if any, can be diagnosed and managed easily.…”

“…[20][21][22][23] Several IOL alignment methods, including manual marking, iris-fingerprinting technique, intraoperative wavefront aberrometry, and automated intraoperative registration systems have been thus evaluated to improve the accuracy of results with toric IOLs. [11][12][13][14][15] Varsits et al, in a recent study evaluated the CALLISTO eye software, an intraoperative toric intraocular lens alignment system with an image-guided system. [15] They concluded that it was an accurate and fast procedure resulting in precise alignment, simplifying the positioning of toric IOLs.…”

“…Post-operative toric IOL positioning was evaluated using ray tracing aberrometry (iTrace, Tracey technologies, Hoya, Japan). In addition, the post-operative toric IOL enhancement software provides the degree of misalignment of the toric IOL, and the direction as well as the magnitude of the required post-operative rotation to achieve optimal results [11][12][13][14][15]. Wavefront aberrometers such as the iTRACE system determine the orientation of the toric IOL based on the internal ocular aberrations.…”

Clinical outcomes and rotational stability following implantation of Eyecryl toric intraocular lens – Results of a 12-months prospective study

“…[ 10 11 12 13 ] Therefore, there are several IOL alignment methods, including manual marking, iris-finger printing technique, intra-operative wavefront aberrometry, and automated intra-operative registration systems, such as the investigated system, or the Verion system (Alcon Laboratories, Inc.). [ 14 15 16 ]…”

Comparison of INTEGRA and the Manual Method to Determine the Axis for Intraocular Lens Implantation—A Case Series of 60 Eyes

“…Automatic systems for determining the axis of the implant are becoming increasingly common. Such methods involve overlaying an image on the eye in real time to guide the incision site and capsulorhexis and they use the Technischer Ausschuss für BrillenOptik (TABO) scale to facilitate axial positioning of the intraocular lens in the eyeball [ 3 , 4 ] ( Figure 1 ).…”