Assessment of toric intraocular lens alignment by a refractive power/corneal analyzer system and slitlamp observation.
OBJECTIVE
To assess the validity of an internal optical path difference map of a refractive power/corneal analyzer system in determining the alignment of toric intraocular lenses (IOLs).


METHODS
Private practices, Spring Hill, Brisbane, and Chermside, Australia.


METHODS
This retrospective study comprised patients with more than 1.5 diopters of preexisting corneal astigmatism who had phacoemulsification and AcrySof toric IOL implantation. Preoperatively, the surgical eye was marked at the slitlamp microscope using a 4-point technique. The desired IOL orientation was marked with a Mendez marker based on the steep corneal axis. The toric IOL axis was measured 3 weeks postoperatively by rotating the slitlamp beam to align with the IOL axis indicator marks and using the Internal OPD Map on the Nidek OPD-Scan system. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, residual refractive sphere, and residual keratometric and refractive cylinders were also measured at 3 weeks.


RESULTS
Postoperatively, the mean UDVA was 0.17 logMAR +/- 0.18 (SD) and the mean CDVA, -0.01 +/- 0.12 logMAR; 88.2% of eyes had a UDVA of 0.3 or better, and no eye lost lines of visual acuity. There was an 82.33% reduction in defocus equivalent and a 64.62% reduction in refractive cylinder. The mean IOL misalignment measured by slitlamp was 2.55 +/- 2.76 degrees and by the internal map, 2.65 +/- 1.98 degrees. The correlation between the 2 methods was highly significant (r = 0.99, P<.001).


CONCLUSIONS
Both refractive power/corneal analyzer system and slitlamp observation were reliable and predictable methods of assessing IOL alignment. The 4-point preoperative marking technique yielded clinically acceptable, accurate toric IOL alignment.
Brisbane North Eye Centre, 708 Gympie Road, Chermside, Queensland 4032, Australia. careyoptical@hotmail.com
Paul J
PJ
Carey
Antonio
A
Leccisotti
Victoria E
VE
McGilligan
Ed A
EA
Goodall
C B Tara
CB
Moore
D057128:Aberrometry / Q000379:methods*; D000368:Aged; D001251:Astigmatism / Q000517:prevention & control; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D010340:Pathology, Surgical; D018918:Phacoemulsification; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology