Toric outcomes: Computer-assisted registration versus intraoperative aberrometry

Solomon, Jonathan; Ladas, John G.

doi:10.1016/j.jcrs.2017.01.012

Cited by 32 publications

(17 citation statements)

References 23 publications

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“…Furthermore, the postoperative median IOL misalignment was 3° at 1 day and 1 month [19], consistent with the present outcomes. A recent study shows that 28% of the mean toric IOL axis misalignment measured postoperatively is caused by intraoperative misalignment rather than postoperative rotation [20]; also, rotation between 1 hour and 1 day postoperatively was rare [20]. At 1 postoperative year, the mean toric IOL axis misalignment was 6.67°, of which 1.87° were caused by surgical misalignment and 4.80° were caused by toric IOL rotation.…”

Section: Discussionmentioning

confidence: 98%

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

Zhang

Zhou

et al. 2020

Preprint

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Background: There was no standard technique for measuring corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This study evaluated visual outcomes, rotational stability after performing toric intraocular lens (IOL) implantation planning based on the wavefront aberrometry of the cornea with iTrace. Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China. Design: Prospective case series. Methods ： The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Over a 3-month follow-up period, astigmatic changes were assessed using the Alpins vector method. Results ： Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤ 0.50 D increased from 0 to 71.8% postoperatively. Conclusions ： This is the first study evaluating the clinical outcomes of using iTrace wavefront keratometric readings to plan a toric IOL implantation. The findings show that the iTrace built-in toric calculator with wavefront keratometric astigmatism for toric IOL planning is safe and effective.

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Section: Discussionmentioning

confidence: 98%

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

Zhang

Zhou

et al. 2020

Preprint

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“…At 1 postoperative year, the mean toric IOL axis misalignment was 6.67°, of which 1.87° were caused by surgical misalignment and 4.80° were caused by toric IOL rotation. 19 Previous research suggested that a digital overlay system, including intraoperative wavefront aberrometry, and a digital marking system results in lower intraoperative misalignment and postoperative astigmatism than traditional manual marking [18,21,22]. Mayer et al found statistically signi cant differences between manual marking and digital marking with better toric IOL alignment in the digital marking group (2.0 degrees versus 3.4 degrees) [18].…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

Zhang

Zhou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: There was no standard technique for measuring corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This study evaluated visual outcomes, rotational stability after performing toric intraocular lens (IOL) implantation planning based on the wavefront aberrometry of the cornea with iTrace. Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China.Design: Prospective case series.Methods: The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Over a 3-month follow-up period, astigmatic changes were assessed using the Alpins vector method. Results: Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤ 0.50 D increased from 0 to 71.8% postoperatively.Conclusions: This is the first study evaluating the clinical outcomes of using iTrace wavefront keratometric readings to plan a toric IOL implantation. The findings show that the iTrace built-in toric calculator with wavefront keratometric astigmatism for toric IOL planning is safe and effective.Trial registration: Current Controlled Trials ISRCTN94956424, Retrospectively registered (Date of registration: 05 February 2020). http://www.isrctn.com/ISRCTN94956424.

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“…Intraoperative aberrometry, allowing alignment of t-IOLs according to the overall refraction, is the latest development in alignment technology. In direct comparison, the aberrometric (Optiwave Refractive Analysis) adjustment was less accurate (remaining astigmatism 0.46 D) than the image-guided Zeiss Callisto system (residual astigmatism 0.26 D) [13]. Surgically induced transient variations of ocular refraction may have caused the relatively unfavorable outcome of the aberrometric approach.…”

Section: Meridian Of Incisionmentioning

confidence: 97%

A Simple, Inexpensive, and Precise Photographic Method for Intraoperative Toric IOL Alignment

Gerding

Somfai

Langenegger

2019

Klin Monatsbl Augenheilkd

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Background It was the aim of this study to analyse the refractive outcome of toric intraocular lens (t-IOL) implantation guided by a newly developed method of photographic alignment. Material and Methods Fourteen eyes of 10 patients (6 females, 4 males, age 63.4 ± 6.7 (40.6 – 68.0) years [mean ± 1 SD (range)]) were included in this retrospective study. All eyes received an Oculentis Tplus LS-313 (Oculentis, Berlin, Germany) t-IOL after standard phacoemusification (n = 4) or femtocataract laser-assisted surgery (n = 10). Image-guided t-IOL alignment included: (1) calculation of t-IOL parameters (combination of different biometric methods) and plotting a layout drawing of the target lens position, (2) capture of an anterior segment slit lamp photograph in the upright position, (3) superposition of the photographs by the t-IOL target plot and a gradual scale, (4) drawing of marker lines on the photograph and removal of the IOL target coordinates, (5) transfer of the final image to a tablet PC, and (6) marking of the target axis at the corneal limbus with an ink pen in the surgical room. Results Preoperative corneal astigmatism was 2.50 ± 0.97 (1.38 – 4.34) diopters (D) (mean ± 1 SD, range). In all eyes, intraoperative alignment could easily be performed using the photographic target layout. Surgical interventions and postoperative follow-up were without complications in all cases. Residual postoperative astigmatism was 0.16 ± 0.24 (0.00 – 0.75) D (p < 0.001 compared to preoperative astigmatism). In 64% of patients, residual subjective astigmatism was zero, in 93% ≤ 0.5 D, and in 100% ≤ 0.75 D. Postoperative uncorrected logMAR visual acuity (0.05 ± 0.07, range 0.00 – 0.20) and best-corrected visual acuity (0.03 ± 0.05, 0.00 – 0.10) were significantly better (each p < 0.001) than best-corrected preoperative visual acuity (0.21 ± 0.14, 0.00 – 0.49). Conclusions Results of this clinical series clearly indicate that the newly developed photographically guided technique of toric lens alignment leads to highly accurate postoperative results for astigmatic correction.

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Toric outcomes: Computer-assisted registration versus intraoperative aberrometry

Abstract: Intraoperative markerless computer-assisted registration and biometric guidance summarily yielded less remaining refractive cylinder than toric IOL placement guided by intraoperative aberrometry.

Cited by 32 publications

References 23 publications

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

A Simple, Inexpensive, and Precise Photographic Method for Intraoperative Toric IOL Alignment

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