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The direct radial toric marking technique: unprecedented precision

Poster Details

First Author: V.Sugantharaj INDIA

Co Author(s):                        

Abstract Details


To study the precision and predictability of the Direct Radial toric marking technique in achieving precise 'in the bag' toric IOL positioning in 150 patient who underwent toric iol implantations over a six month period.


Vasan Eye Care Hospital, Chennai, Tamilnadu, India.


The 'site of incision' and the 'axis of placement' markings were performed 'directly' on the cornea -without resorting to extrapolation from the reference markings. The markings were made under slit lamp using a 'hockey stick blade', which left thin radial white imprint lines about 3mm long which were easily visible under the operating microscope. Toric IOL implantations were achieved with the guidance of these radial lines- the end point being that the toric markings on the IOL and the radial corneal markings are superimposed, or parallel when the purkinje 1 and 3 images coincide.


with this new marking strategy 90% of the Toric IOls implanted were within 2 degrees of the intended axis of placement, 8 % within 5 degrees and only 2 % were between 5-10 degrees away from the intended axis of placement. The alignment checks were performed under dilated slit lamp examination on the 1st PO day, one week PO, one month PO and six months PO.


The Direct Radial Toric marking technique does not suffer from extrapolation errors of reference markings, creates fine white radial lines instead of a big 2-3 degree blob of dye mark, is unaffected by saccadic movements of the eyeball as in projection axis systems and the radial lines aid in easy alignment of the toric IOL. It is easy to do, inexpensive and ensures unprecedented precision.

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