Journal of cataract and refractive surgery最新文献

{"title":"Refractive accuracy of the new Barrett formula using segmented axial length compared with that of the traditional Barrett Universal II formula.","authors":"Seiichiro Hata, Manabu Kobayashi","doi":"10.1097/j.jcrs.0000000000001609","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001609","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the refractive accuracy of the Barrett True axial length (BTAL) formula, newly integrated into ARGOS, with that of the Barrett Universal II (BUII) formula calculated using axial length (AL) from IOL Master 700.</p><p><strong>Setting: </strong>Private clinics in Kanagawa, Japan.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>We assessed eyes of patients who underwent cataract surgery with SY60WF IOL implantation, using ARGOS and IOL Master 700. The predicted refraction for BTAL was back-calculated. Refractive prediction errors (RPEs) for BTAL, BUII with ARGOS (segmented BUII), and BUII with IOL Master 700 (composite BUII) were compared. We primarily aimed to demonstrate the non-inferiority of BTAL to composite BUII in absolute RPE.</p><p><strong>Results: </strong>We included 209 eyes from 209 patients. BTAL met the non-inferiority criteria, as the upper confidence interval (CI) boundary was below the non-inferiority margin of 0.10 diopters (D) for the difference in absolute RPE (-0.03 D; 95% CI: -0.06 to 0.01). In short eyes (AL ≤ 22.5 mm), the median absolute RPEs for BTAL, segmented BUII, and composite BUII were 0.25, 0.18, and 0.37 D, respectively, with significant differences between BTAL and composite BUII (p = 0.028) and segmented BUII and composite BUII (p = 0.018). In long eyes (AL > 26 mm), the median absolute RPEs were 0.21, 0.20, and 0.28 D for BTAL, segmented BUII, and composite BUII, respectively.</p><p><strong>Conclusions: </strong>BTAL was non-inferior to composite BUII in absolute RPE. BTAL is an accurate and useful intraocular lens power calculation formula, even in eyes with short and long AL.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of venturi versus peristaltic based phacoemulsification in femtosecond laser cataract surgery: Venturi vs peristaltic based phacoemulsification for cataract.","authors":"Rachel A Scott, Caleb J Holtmeyer, Travis M Parker, Jessica K Willis, Wendell J Scott, Randall J Olson","doi":"10.1097/j.jcrs.0000000000001618","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001618","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficiency of peristaltic vs venturi vacuum platforms when applied to the femtosecond treated cataract.</p><p><strong>Setting: </strong>Outpatient Eye Center, Mercy Health System, Springfield, MO, USA.</p><p><strong>Design: </strong>This is a prospective randomized controlled trial of 111 patients with moderate nuclear sclerosis scheduled for bilateral routine laser cataract surgery (clinicaltrials.gov; NCT03970525).</p><p><strong>Methods: </strong>Patients were randomized to receive surgery in one eye with a peristaltic system and the other with a venturi system. The vacuum and phaco power were the same for both systems. The primary outcomes were EFX, UST (ultrasound time), PIOT (phaco in/out time), surgery time (speculum in/out time), and the ECC (endothelial cell count).</p><p><strong>Results: </strong>The type of vacuum/phacoemulsification system used during laser cataract surgery had a significant impact on the four procedural outcomes. Specifically, phacoemulsification energy (EFX), ultrasound time (UST), phaco tip in/out time (PIOT), and total microscope time (speculum in/out case time) were lower when the venturi system was used compared to the peristaltic system (t(100)=-4.28, p <.001). The vacuum system used did not impact the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) or central cornea thickness (CCT). ECC decreased 6.38% with venturi and 8.32% with peristaltic (t(87) = 1.19, p = .235). There were no complications.</p><p><strong>Conclusion: </strong>Venturi-based phaco was more efficient than peristaltic, based on energy and time, when used for removal of the femtosecond treated cataract.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating ASC-4 Transfer Rates in Cataract Surgery: Insights into Timing and Causes of Hospital Transfers.","authors":"Nicholas R Stange, Matthew P Rauen","doi":"10.1097/j.jcrs.0000000000001613","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001613","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the causes, timing, and contributing factors of direct hospital transfer cases from an ophthalmology-specific ambulatory surgery center and to identify potential strategies for decreasing future transfers.</p><p><strong>Setting: </strong>A large ophthalmology surgery center in Des Moines, Iowa.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Methods: </strong>A retrospective chart review was performed on patients requiring hospital transfer from a Midwest ophthalmology-specific surgery center from March 2022 through July 2024. Variables reviewed included patient demographics, comorbidities, prior surgeries/surgical complications, results of pre-operative physical exams, type of surgery and anesthesia performed, the type and timing of each complication, and the reasons for transfer. Each transfer was assessed for its necessity, preventability, and outcome.</p><p><strong>Results: </strong>A total of 22 patients required hospital transfer out of 24,960 admissions for a rate of 0.88 per 1,000 admissions (95% CI: 0.58-1.33). Only 5 (23%) transfer cases were temporally related to anesthesia or surgery. The other 17 (77%) had concerns first noted prior to the induction of anesthesia. Nine (41%) of the surgeries were completed, 1 (5%) partially completed, and the remaining 12 (55%) surgeries were cancelled. The reasons for transfer were largely cardiac and/or blood pressure related (18/22, 82%). Nearly a third of the transfers (7/22, 32%) were considered preventable.</p><p><strong>Conclusion: </strong>Hospital transfers from ASCs are rare and all-cause hospital transfer rates may overestimate the true risk of ocular surgery. Most patients requiring hospital transfer were identified in the pre-operative area. Greater attention to preoperative physical exam reports could potentially prevent some hospital transfers.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of physiological tilt of the phakic eye using biometry parameters and anterior segment optical coherence tomography: Measuring Eye Tilt with High-Res Swept Source OCT.","authors":"Haidar Khalil, Theresa Höftberger, Peter Laubichler, Klemens Waser, Leon Pomberger, Paul Jirak, Nino Hirnschall, Matthias Bolz","doi":"10.1097/j.jcrs.0000000000001614","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001614","url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively evaluate the tilt of the crystalline lens in phakic eyes and its relationship with optical biometry parameters.</p><p><strong>Setting: </strong>The retrospective analysis was conducted at the Department for Ophthalmology and Optometry, Kepler University Clinic in Linz, Austria.</p><p><strong>Design: </strong>Lens tilt assessment was performed through a combined analysis of optical biometry (IOL Master 700) and anterior segment optical coherence tomography (AS-OCT) data to understand its relationship.</p><p><strong>Methods: </strong>The study analyzed preoperative biometry data and AS-OCT images from 4689 eyes of 2489 patients prior to cataract surgery. The optical biometry parameters were correlated with the degree of lens tilt using logistic regression and machine learning techniques.</p><p><strong>Results: </strong>The average lens tilt was 4.9°, with 6.7% of eyes showing a tilt greater than 7°. Significant associations were found with specific biometry parameters, such as anterior chamber depth (ACD), axial length (AL), equator thickness and lens decentration. The developed predictive model for assessing tilt risk demonstrated a high accuracy with an area under the curve of 0.862.</p><p><strong>Conclusions: </strong>The findings highlight the average lens tilt of 4.9° in a cataract patient cohort. This analysis contributes to a broader understanding of lens orientation and its interactions with biometric parameters.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depth of focus as a function of spherical aberration using adaptive optics in pseudophakic subjects.","authors":"Juan Tabernero, Carles Otero, John Kidd, Laura Zahiño, Ana Noia, Jose Luis Güell, Pablo Artal, Shahina Pardhan","doi":"10.1097/j.jcrs.0000000000001608","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001608","url":null,"abstract":"<p><strong>Purpose: </strong>To measure visual acuity at three different defocus planes in pseudophakic subjects with varying levels of spherical aberration induced by an adaptive optics visual simulator. The study aimed to simulate Extended Depth of Focus (EDOF) intraocular lenses (IOLs).</p><p><strong>Setting: </strong>Private hospital (IMO, Barcelona, Spain).</p><p><strong>Design: </strong>Observational case series; modelling theory.</p><p><strong>Methods: </strong>Through-focus visual acuity was measured in 26 pseudophakic subjects (age 63 ± 10 years old) with an adaptive optics visual simulator optimized for clinical use (VAO, Voptica SL, Murcia, Spain). Measurements were made under five different conditions of induced negative spherical aberration: 0, -0.07, -0.15, -0.23 and -0.30 μm (pupil diameter: 4.5 mm). Results were also modelled using ray tracing simulations.</p><p><strong>Results: </strong>On average, depth of focus was extended when spherical aberration increased from -0.07 to -0.15 μm (4.5 mm pupil diameter). Some indivisuals (27%) experienced improved depth of focus with higher magnitudes of spherical aberration, while others (23%) exhibited no benefit from increased (negative) SA, as visual acuity dropped below acceptable levels. Depth of focus calculations based on ray tracing showed general agreement with the measurements.</p><p><strong>Conclusions: </strong>The visual conditions of EDOF IOLs were artificially recreated in a population of pseudophakic patients implanted with a monofocal IOL. The variability seen across subjects in visual acuity at different defocus planes suggests that visual simulators might be capable of screening subjects for suitability and tolerability of these advanced technology lenses.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual outcomes, contrast sensitivity and defocus profile with an aspheric monofocal intraocular lens utilizing positive spherical aberration.","authors":"Elizabeth M Law, Rajesh K Aggarwal, Phillip J Buckhurst","doi":"10.1097/j.jcrs.0000000000001612","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001612","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual outcomes following bilateral implantation of the RayOne EMV intraocular lens with targeted micro-monovision.</p><p><strong>Setting: </strong>Southend Private Hospital, UK.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Methods: </strong>50 subjects (100 eyes) assessed at 12 to 18 months post-operatively. Emmetropia was targeted in the dominant eye and myopia of -0.50 to -1.00D in the non-dominant eye. Uncorrected and distance corrected visual acuity was assessed monocularly and binocularly at distance (6m), intermediate (70cm) and near (40cm). Defocus was assessed from +1.50D to -4.00D monocularly and binocularly. Contrast sensitivity was assessed using a computerised Pelli-Robson chart.</p><p><strong>Results: </strong>Mean Spherical Equivalent (MSE) was -0.05±0.34D and -0.91±0.60D in the dominant and non-dominant eyes respectively. Uncorrected distance visual acuity (UDVA) was significantly different in the dominant (0.08±0.10LogMAR) and non-dominant eye (0.29±0.17LogMAR). (p<0.01). Corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were similar between eyes. However, significant differences were found between binocular uncorrected intermediate visual acuity (UIVA) (0.16±0.11LogMAR) and DCIVA (0.31±0.11LogMAR) (p <0.01) also, binocular uncorrected near visual acuity (UNVA)(0.30±0.17LogMAR) and DCNVA (0.50±0.19 LogMAR) (p<0.01). The non-dominant eye shows superior acuity eye in both UIVA (p<0.01) and UNVA(p<0.01). Contrast sensitivity showed no significant difference between eyes (p = 0.06). Significant improvement binocularly compared to monocularly was seen through imposed defocus -0.50 to -2.50D.</p><p><strong>Conclusion: </strong>The RayOne EMV with micro-monovision is a reliable method for improving intermediate and near visual acuity, by increasing the range of focus without compromise of distance acuity or contrast sensitivity.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meibomian Gland Structure and Function in Patients with Demodex Blepharitis.","authors":"Elizabeth Yeu, Cecelia Koetting","doi":"10.1097/j.jcrs.0000000000001619","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001619","url":null,"abstract":"<p><strong>Purpose: </strong>To compare structural and functional measures of meibomian gland dysfunction (MGD) in eyes with moderate to severe Demodex blepharitis (collarette grade 2-4) compared to those with collarette grade 0 (0-2 collarettes).</p><p><strong>Setting: </strong>Private clinical practice.</p><p><strong>Design: </strong>Retrospective, single-center, non-interventional, observational study.</p><p><strong>Methods: </strong>In this study, case records of patients aged ≥18 years with data available for collarettes and MGD signs (telangiectasia, meibum expressibility, meibum quality, and meibography) were included. Outcome measures were the comparison of the mean telangiectasia score, meibum expressibility score, meibum quality score, and meibomian gland atrophy score between eyes with moderate to severe Demodex blepharitis (collarette grade 2 to 4, or >10 collarettes) and those with collarette grade 0 (0-2 collarettes). Right and left eyes were analyzed separately.</p><p><strong>Results: </strong>The mean telangiectasia, meibum quality, and meibomian gland atrophy scores were statistically significantly worse in the collarette grade 2-4 group than in those in the collarette grade 0 group for both right and left eyes (even adjusting for age). There was a positive correlation between collarette grade and telangiectasia, meibum quality and meibomian gland atrophy scores.</p><p><strong>Conclusion: </strong>Structural and functional measures of MGD were significantly worse in eyes with collarette grade 2-4 than in those with collarette grade 0. Clinicians should routinely examine their patients for Demodex infestation and signs of MGD and treat both conditions as needed, especially in the perioperative setting.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Intraocular Lens Power Calculation Based on Distance from Haptic to Principal Object Plane.","authors":"Youngsub Eom, Seul Ki Yang, Minji Woo, Jae-Ik Kim, Kwang Eon Choi, Dong Hyun Kim, Hwa Lee, Young-Woo Suh, Jong Suk Song, David L Cooke","doi":"10.1097/j.jcrs.0000000000001611","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001611","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of the distance from the most-anterior surface of the optic to the principal object plane (POP) and from the foremost haptic to the principal object plane (H-POP) on the intraocular lens (IOL) power calculation.</p><p><strong>Setting: </strong>A tertiary hospital.</p><p><strong>Design: </strong>Optical simulation and retrospective cross-sectional study.</p><p><strong>Methods: </strong>The optical simulation study plotted changes in the POP and H-POP as a function of IOL power using ICB00 IOL configuration data. The clinical study included 102 eyes of 102 patients implanted with ICB00 IOL to examine the correlation between changes in both the POP and the H-POP, and the prediction error calculated using the Barrett Universal II formula with varying IOL power.</p><p><strong>Results: </strong>The ICB00 IOL showed minor fluctuations in the POP (0.21 mm to 0.30 mm) with changing IOL power. The H-POP increased stepwise from 5.0 D, peaking at 0.60 mm at 16.0 D, then decreased to a minimum of 0.14 mm at 34.0 D. The prediction error graph primarily mirrored the pattern of changes in the H-POP rather than the POP with varying IOL power. Linear regression showed a significant myopic shift in prediction error as IOL power increased beyond 16.0 D (Y = -0.069X+1.420, R2=0.178, p<0.001).</p><p><strong>Conclusion: </strong>For the ICB00 IOL, the H-POP has more impact on IOL power calculation than the POP itself. For more accurate IOL power calculations, it is essential for all IOL manufacturers to provide comprehensive information on both optic and haptic geometries, which will enable the precise calculation of H-POP.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxic Anterior Segment Syndrome: A 2012-2022 Update on the Most Common Causes.","authors":"Melissa Yao, Shwetha Mudalegundi, Kevin Eid, Nour Bundogji, Neil Kelkar, Liliana Werner, Nick Mamalis","doi":"10.1097/j.jcrs.0000000000001610","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001610","url":null,"abstract":"<p><strong>Purpose: </strong>To identify trends in the reporting of toxic anterior segment syndrome (TASS) to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Force from 2012-2022.</p><p><strong>Setting: </strong>John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>TASS questionnaires on instrument cleaning and sterilization, and extraocular and intraocular products used during cataract surgery were available on the American Society of Cataract and Refractive Surgery website. A retrospective analysis of questionnaires submitted by surgical centers reporting cases of TASS was performed between January 1, 2012, and December 31, 2022, to identify commonly held practices that could cause TASS.</p><p><strong>Results: </strong>Data from 77 questionnaires were analyzed. The reporting centers performed 56,319 cataract surgeries and reported 539 cases of TASS from January 1, 2012, to December 31, 2022. Common practices associated with the TASS outbreaks in the surveys included re-use of single-use cannulas, phacoemulsification, and irrigation/aspiration tips (69%), use of enzymatic cleaners (40%), inadequate flushing of phacoemulsification and irrigation/aspiration handpieces (27%), reuse of phacoemulsification tubing (22%), use of preservative-containing intracameral anesthetic (18%), and addition of antibiotics to balanced salt solution (17%).</p><p><strong>Conclusions: </strong>The surveys identified commonly held practices associated with TASS while showcasing trends over the past 10 years. Understanding these findings and the safe alternatives will allow surgical center personnel to change their practices as needed to prevent this complication.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital vs manual axis marking for toric phakic intraocular lens alignment: prospective randomized intraindividual trial.","authors":"Wolfgang List, Martin Dirisamer, Wolfgang Johann Mayer, Mehdi Shajari, Wilfried Glatz, Jakob Gran, Andreas Wedrich, Gernot Steinwender","doi":"10.1097/j.jcrs.0000000000001553","DOIUrl":"10.1097/j.jcrs.0000000000001553","url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual and refractive outcomes and postoperative axis alignment for toric implantable collamer lens (ICL) implantation in astigmatic myopia using manual vs digital marking techniques.</p><p><strong>Setting: </strong>Department of Ophthalmology, Medical University of Graz, Graz, Austria.</p><p><strong>Design: </strong>Prospective randomized single-centered intraindividual comparison.</p><p><strong>Methods: </strong>Patients undergoing bilateral toric ICL implantation for myopia with astigmatism ≥0.5 diopters (D) were enrolled. Patients received both marking techniques, and randomization was performed. Postoperative retroillumination photography assessed axis alignment, and visual and refractive parameters were evaluated. Duration of the surgeries was recorded.</p><p><strong>Results: </strong>The study included 20 patients and 40 eyes. Preoperative visual and refractive parameters showed no significant differences. Postoperatively, residual astigmatism ( P = .824) and spherical equivalent ( P = .309) were comparable. No notable differences between right and left eyes in preoperative ( P = .371) and postoperative ( P = .824) astigmatism were observed. Although slight, corrected distance visual acuity (CDVA) increased in both groups postoperatively ( P = .381). Gain in CDVA was comparable between marking techniques ( P = .637). Safety and efficacy indices were comparable ( P = .991 and P = .189, respectively). Postoperative axial misalignment was 2.8 ± 3.1 degrees in the digital- and 4.4 ± 5.1 degrees in the manual group ( P = .260). Vector analysis showed no significant differences between manual and digital marking. Duration remained uninfluenced by the marking technique ( P = .970) and side of surgery ( P = .682).</p><p><strong>Conclusions: </strong>Digital and manual marking techniques provided comparable results in axis alignment, surgical duration, and visual and refractive outcomes. Both methods were viable for precise axis alignment, with digital marking offering a potential advantage in efficacy.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"23-30"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}