Kodavoor Shreesha K, Divya J, Dandapani Ramamurthy, Ramamurthy Chitra, Ramamurthy Shreyas, Sachdev Gitansha
The Eye Foundation, Coimbatore, Tamil Nadu, India.
Indian J Ophthalmol. 2020 Dec;68(12):3020-3024. doi: 10.4103/ijo.IJO_465_20.
The aim of this study was to compare the visual outcome of participants undergoing toric intraocular lens (IOL) implantation after cataract extraction using manual marking versus digital marking for intraoperative guidance.
Randomized controlled trial of participants with cataract and corneal astigmatism of 1.00 D-4.50 D. The eyes were grouped into manual marking (Group 1) and digital marking (Group 2). Preoperative Uncorrected distance visual acuity (UDVA), Corrected distance visual acuity (CDVA), and corneal astigmatism were determined. IOL power and axis of alignment were determined using Barrett toric calculator. Eyes were marked by bubble marker and Mendez ring in group 1 and by VERION (Alcon, Fort Worth, Texas) digital overlay in Group 2. Postoperatively, UDVA, CDVA, residual refractive cylinder and IOL misalignment were determined (iTrace system, Tracey technologies) at 1 week, 6 weeks, and 3 months.
A total of 61 eyes of 50 participants, 31 in Group 1 and 30 in Group 2, were studied. The mean postoperative cylindrical error was 0.50 ± 0.39 D in Group 1 and 0.29 ± 0.34 D in Group 2 (P = 0.03). 67.74% (n = 21) and 93.55% (n = 29) eyes achieved a residual astigmatism of ≤0.50 D and ≤1.00 D, respectively, in Group 1, whereas 83.33% (n = 25) and 100% (n = 30) eyes achieved a residual astigmatism of ≤0.50 D and ≤1.00 D, respectively, in Group 2 at 3 months postoperatively. Toric IOL misalignment was 4.71 ± 3.12° in Group 1 and 4.03 ± 2.99° in Group 2 (P = 0.39).
Accurate manual marking and digital marking are equally effective guides for toric IOL alignment, intraoperatively.
本研究旨在比较白内障摘除术后接受散光人工晶状体（IOL）植入的参与者在术中使用手动标记与数字标记进行引导时的视觉效果。
对患有白内障且角膜散光为1.00 D - 4.50 D的参与者进行随机对照试验。将眼睛分为手动标记组（第1组）和数字标记组（第2组）。测定术前未矫正远视力（UDVA）、矫正远视力（CDVA）和角膜散光。使用巴雷特散光计算器确定IOL屈光度和轴向。第1组用气泡标记和门德斯环标记眼睛，第2组用VERION（爱尔康，沃思堡，德克萨斯州）数字叠加标记眼睛。术后，在1周、6周和3个月时使用iTrace系统（Tracey技术公司）测定UDVA、CDVA、残余屈光柱镜和IOL偏心。
共研究了50名参与者的61只眼睛，第1组31只，第2组30只。第1组术后平均柱镜误差为0.50±0.39 D，第2组为0.29±0.34 D（P = 0.03）。术后3个月时，第1组分别有67.74%（n = 21）和93.55%（n = 29）的眼睛残余散光≤0.50 D和≤1.00 D，而第2组分别有83.33%（n = 25）和100%（n = 30）的眼睛残余散光≤0.50 D和≤1.00 D。第1组散光IOL偏心为4.71±3.12°，第2组为4.03±2.99°（P = 0.39）。
在术中，准确的手动标记和数字标记对于散光IOL的轴向对准同样有效。
