Comparative Accuracy Of Image-Guided Systems And Smartphone Applications For Enhanced Monofocal Toric Iol Alignment In Cataract Surgery
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT635 | Type: Free paper | DOI: 10.82333/y37j-ex38
Authors: Prof. Dr So-Hyang Chung 1 , Prof. Dr Soonwon Yang 1 , Dr Ji-Yun Song 1 , Dr Dohyeon An* 1
1Ophthalmology,The Catholic University of Korea,Seoul ,Korea, Republic Of
Purpose
To compare the clinical outcomes of cataract surgery with toric intraocular lenses
(IOLs) using two different alignment methods: an image-guided system and a smartphone
application-guided method, and to evaluate their efficacy, feasibility, and potential for improving
accessibility.
Setting
Seoul St.Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Methods
This retrospective study analyzed 171 eyes of 120 patients undergoing cataract
surgery with an enhanced monofocal toric IOL (Eyhance, Johnson & Johnson Inc., USA).
Because some patients contributed both eyes, within-patient correlation was accounted for
using generalized estimating equations (GEE). Outcomes included toric alignment error and
refractive outcomes.
Results
Mean absolute alignment error was 1.37±1.29° in the image-guided group and
1.84±1.47° in the smartphone-guided group. In clustered GEE analysis, the smartphone
workflow was associated with higher absolute alignment error (p=0.04). Postoperative
refractive cylinder and spherical equivalent prediction accuracy were similar between groups.
Conclusions
Both systems demonstrated excellent refractive outcomes. The image-guided
system provides superior accuracy in total absolute alignment error. While the smartphone
application also provides comparable outcomes, it offers a cost-effective alternative, expanding
accessibility in resource-limited settings.