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Correcting corneal astigmatism during cataract surgery can be achieved via different incision techniques – such as LRI or AK – but the outcome may be limited due to the dependance on factors such as incision size, location, tunnel length and corneal dimensions.1 Toric IOLs have been clinically proven to be one of the best options for astigmatism correction during cataract surgery. The correct and precise alignment of the IOL placement is essential to achieve excellent refractive outcomes.
Different methods for toric IOL alignment
Clinical solution
When using toric IOLs, different methods for alignment can be used. Computer assisted surgery for toric IOL implantation and alignment has proven to be an efficient alternative to manual marking and can be digitally integrated within the workflow. The ease of the alignment during surgery can also differ from the IOL haptic shape. In addition, small 0.5 D cylinder steps of ZEISS toric IOLs may improve precision of astigmatism correction.1
Where C-loop lenses can usually only be rotated clockwise, ZEISS toric IOLs have the advantage of an easy 360° rotation in both directions.
Digital intraoperative assistance of ZEISS CALLISTO eye for simple alignment of ZEISS toric IOLs
ZEISS solution
ZEISS offers full and easy digital integration of diagnostic data, planning and surgical procedure. A biometry reference image from the IOLMaster® from ZEISS is transferred to ZEISS CALLISTO eye and the individual data are used to create overlays of the target axis in the eyepiece. The eye tracking function automatically compensates for eye movements. ZEISS toric IOLs can be easily aligned in both directions to the displayed target axis thanks to their clearly visible toric marks and their symmetric 4-haptic design. A study showed that mean toric IOL alignment time as well as the mean overall time was significantly shorter when using ZEISS CALLISTO eye compared to manual marking. In addition, mean toric IOL alignment at 3-months visit was significantly more accurate in the digital group.2
I save 6 minutes per patient and improve alignment by 40% compared to manual marking.2
ZEISS solutions for correcting astigmatism during cataract surgery
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ZEISS toric IOLs
Toric IOLs from ZEISS are all based on the same bitoric optical design. The wide choice of the ZEISS toric IOL portfolio enables you to achieve excellent refractive outcomes in line with your patients preferences and clinical condition; from monofocal toric to EDoF toric to trifocal toric lenses.
Precise IOL selection out of ~2000 options: smaller 0.5D cyl steps, up to 12D in cyl
Proven3 rotational stability thanks to 4-haptic fixation
Effortless handling thanks to preloaded injector system and easy alignment
With ZEISS CALLISTO eye markerless alignment, manual marking steps can be skipped altogether for efficient2 and precise4 toric IOL alignment to reduce residual astigmatism.
McAlinden, C., & Janicek, D. (2021). Toric Intraocular Lenses for the Management of Corneal Astigmatism at the Time of Cataract Surgery. Journal of Ophthalmology, 1-6. https://doi.org/10.1155/2021/3286043
2
Mayer, W. J., Kreutzer, T., Dirisamer, M., Kern, C., Kortuem, K., Vounotrypidis, E., Kook, D. (2017). Comparison of visual outcomes, alignment accuracy, and surgical time between 2 methods of corneal marking for toric intraocular lens implantation. J Cataract Refract Surg, 43(10), 1281-1286. doi:10.1016/j.jcrs.2017.07.030
3
Mencucci, R. et al., Clinical outcomes and rotational stability of a 4-haptic toric intraocular lens in myopic eyes, 2014, JCRS,40: 1479-1487
4
VIROS research team of Prof. Findl: Clinical data of Dr. Varsits "Deviation between the postoperative (at the end of surgery in the operating room) and aimed IOL axes was 0.52 degrees± 0.56 (SD)" published in J Cataract Refract Surg 2019; 45:1234–1238 and Clinical data of Dr. Hirnschall presented at ESCRS 2013.