Kiessling David, Roessler Gernot F, Widder Randolf A
Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Gladbacher Str. 26, 40219, Düsseldorf, Germany.
Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
Int Ophthalmol. 2025 Mar 14;45(1):98. doi: 10.1007/s10792-025-03479-5.
To determine the accuracy of two axis-marking methods for toric intraocular lens (IOL) implantation, one picture-assisted approach based on scleral vessel vectors, and the other based on a self-leveling device for manual marking.
This retrospective single-center study involved 60 eyes of 51 participants, who underwent phacoemulsification with toric IOL implantation. In all eyes, preoperative markings were made in a seated position both manually via a self-leveling corneal marker (RoboMarker), and digitally on slit-lamp photographs, defining scleral vessels as landmarks, aiding to find the correct intraoperative orientation for an angular graduation instrument. The axis of IOL alignment at the end of surgery was determined from high resolution, intraoperative footage from a microscope-integrated camera and the axis-marking error served as an outcome measurement for both marking techniques. The endpoint was the alignment of the lens at the end of surgery.
The average axis-marking error was 2.5 ± 1.9 degrees for picture-assisted marking, which was significantly less than that of the self-leveling corneal marker, being 5.4 ± 4.4 degrees.
Our results indicate that scleral vessel vector marking leads to highly accurate toric IOL alignments, while being an inexpensive technique, as solely a slit-lamp camera is required for preoperative preparation.
确定两种用于植入散光人工晶状体（IOL）的轴标记方法的准确性，一种是基于巩膜血管向量的图片辅助方法，另一种是基于手动标记的自水平装置。
这项回顾性单中心研究纳入了51名参与者的60只眼睛，这些眼睛接受了散光IOL植入的超声乳化手术。在所有眼睛中，术前标记均在坐位时进行，一种是通过自水平角膜标记器（RoboMarker）手动标记，另一种是在裂隙灯照片上进行数字标记，将巩膜血管定义为地标，以帮助找到角度分度仪的正确术中方向。手术结束时IOL对准的轴由显微镜集成摄像头的高分辨率术中图像确定，轴标记误差作为两种标记技术的结果测量指标。终点是手术结束时晶状体的对准情况。
图片辅助标记的平均轴标记误差为2.5±1.9度，明显小于自水平角膜标记器的误差，后者为5.4±4.4度。
我们的结果表明，巩膜血管向量标记可实现高度准确的散光IOL对准，同时该技术成本低廉，因为术前准备仅需一台裂隙灯相机。
