![]() 9 Although the ORA is able to determine the magnitude and axis of a toric IOL, concerns exist about the influence of external variables, such as the eyelid speculum, dry eye, intraocular pressure, and corneal hydration, on the intraoperative measurements. Studies evaluating intraoperative aberrometry have also demonstrated mixed results. ![]() "Every 3º of toric IOL misalignment causes a 10% reduction in intended astigmatism correction." Neither study’s findings were statistically significant for differences in residual astigmatism or distance UCVA. Montes de Oca et al, 6 however, found slightly more misalignment errors with digital marking using the TrueVision 3D system. 5,6,9 Looking at the image-guided systems, Webers et al 5 found a higher rate of toric IOL misalignment in the manual-marking group compared with the Verion group. However, none revealed superiority of one technique over another. Studies have been conducted to compare these new technologies with traditional manual marking. Intraoperative aberrometry systems, such as Optiwave Refractive Analysis with VerifEye+ ( »ORA Alcon) 1,2,9 and Holos IntraOp (Clarity Medical Systems).Femtosecond laser intrastromal marking with the IntelliAxis-L System ( »Lensar) or ✼atalys femtosecond laser (Johnson & Johnson) 1,2,7,8 and.Image-guided systems, such as the »Verion Reference Unit (Alcon), »TrueVision Smart 3D visualization system (TrueVision), and ✼allisto Eye (Carl Zeiss Meditec) 1,2,5,6.5 In the past few years, several new approaches have been introduced. Manual marking has been considered the gold-standard technique to ensure accurate alignment for years. Every 3º of toric IOL misalignment causes a 10% reduction in intended astigmatism correction a rotation of 30º can negate the IOL’s entire cylindrical effect. Toric IOLs can correct up to 4.00 D of corneal astigmatism, but their accurate alignment and precise placement in the capsular bag are essential to achieving the targeted refractive outcome. The standard methods for correcting corneal astigmatism during cataract surgery include (1) adjusting wound size and location, (2) placing relaxing incisions at the steepest meridian, and (3) implanting a toric IOL. 1-5 Left uncorrected, this condition can lead to spectacle dependence and patient dissatisfaction, especially in patients implanted with presbyopia-correcting IOLs. WaveLight ® Excimer Laser Systems Important Product InformationĪpproximately 20% to 30% of patients undergoing cataract surgery have at least 0.75 D of corneal astigmatism. How Testing for the Topography-guided CONTOURA Procedure Fits the Diagnostic Environment and Aids Patient Flow Selecting Candidates for CONTOURA Vision, Topography-Guided LASIKĮndorsing CONTOURA Vision, Topography-Guided LASIK Scleral Contact Lenses for Neurotrophic KeratopathyĪdding CONTOURA Vision, Topography-Guided LASIK to the Refractive Armamentarium Intracameral Endophthalmitis Prophylaxis: Where We Stand Proposed Guideline Raises Concerns About Cataract Anesthesia Coverage
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