Journal Article

Original manual marking versus digital marking for toric intraocular lens alignment

Nemsitsveridze, M.N., Sosnovskii, S.V., Shiryaev, I.V., Boiko, E.V., Shukhaev, S.V.

2025

Overview

Purpose. To compare the original method of single-step manual marking of the position axis of a toric intraocular lens with the marking made by a digital image-guided system (Verion, Alcon Inc.). Material and methods. The study included 90 patients (130 eyes) who underwent phacoemulsification with implantation of toric IOLs from various manufacturers. The original manual and digital Verion markings were used to position the toric IOL. The following parameters were evaluated: the technical ability of marking, intraoperative stability of the marking axis position, intraoperative deviation of digital marking from manual one and the manual marking condition in the postoperative period. Results. Manual marking was applied in 100%, digital marking in 87%. In 17 cases (13%), digital marking could not be used due to post-keratotomic scars (70.6%), corneal opacities (17.6%) and the inability to match images (11.8%). Manual marking has always had a stable position. The digital marking had only one stable located axis in 34 cases (30.1%), or two or more variants of the axis location in 79 cases (69.9%). In most cases 90 (79.6%), the intraoperative deviation of manual marking from digital marking was within 2 degrees, in the range of 3–5, 6–10 and 11–20 degrees, 5 (4.4%), 11 (9,8%) and 7 (6,2%) of cases, respectively. 1 day and 1 month after the surgery, the manual marking was visualized in 100%, after 11–14 months in 25 (69.4%) of cases. Conclusion. The proposed method of manual marking of the toric IOL is not inferior to digital systems, while it is convenient, safe, universal and can be used to assess the rotational stability of toric IOL in the early and late postoperative period, in all medical institutions. Key words: toric IOL, manual marking, digital marking