Anterior stromal puncture with staining: A modified technique for preoperative reference corneal marking for toric lenses and its retrospective analyses.
BACKGROUND
Toric intraocular lenses (IOLs) are an effective way of compensating preexisting corneal astigmatism during cataract surgery. To achieve success, it is imperative to align the toric IOLs in desired position and preoperative reference marking is one among the three important steps for accurate alignment. To make the marking procedure simpler and effective, we have modified the conventional three-step slit lamp-based technique.


METHODS
Patient is seated in front of the slit lamp and asked to keep the chin over chin rest. A 26-gauge bent needle with tip stained by sterile blue ink marker is used to make anterior stromal puncture (ASP) at the edges of horizontal 180° axis near the limbus.


RESULTS
A total of 58 eyes were retrospectively evaluated. Mean (+/-SD) IOL deviation on day 1 and day 30 was 5.7 ± 6.5° and 4.7 ± 5.6°, respectively. Median IOL misalignment on day 1 and day 30 was 3°. Redialing of IOL was required in 2 (3.4%) eyes only, all of which were performed within 1 week of surgery. In total, 2 (3.7%) eyes had a residual astigmatism of - 0.5 Dcyl and - 1.0 Dcyl, respectively.


CONCLUSIONS
ASP is an effective technique for reference marking, technically simpler and can be practiced by most of the surgeons. It avoids the necessity of high-end sophisticated machinery and gives a better platform for the reference corneal marking along with the benefit of reproducibility and simplicity.
Vitreo-retinal Services, Aravind Eye Hospital, Puducherry, India.
Sahil
S
Bhandari
Cataract and Refractive Services, Aravind Eye Hospital, Puducherry, India.
Manas
M
Nath
D059925:Anatomic Landmarks; D001251:Astigmatism / Q000601:surgery; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011300:Preoperative Care; D011677:Punctures; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013194:Staining and Labeling; D014792:Visual Acuity
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