Comparative Accuracy Of Argos Digital Marking And Manual Marking For Toric Iol Alignment: Updated Results
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT646 | Type: Poster | DOI: 10.82333/0v30-k181
Authors: Dr Yi Hsuan Li* 1 , Dr Yuan Sheng Wang 2 , Dr Yu Lun Lo 3 , A/Prof. Chao Kai Chang 1
1Nobel Eye Institute,Taipei,Taiwan, 2Ophthalmology,Shin Kong Wu Ho Su Memorial Hospital,Taipei,Taiwan;Nobel Eye Institute,Taipei,Taiwan, 3Nobel Eye Institute,Taichung,Taiwan
Purpose
To compare the accuracy of toric intraocular lens (IOL) axis alignment using digital marking guided by the ARGOS biometer versus conventional manual marking in cataract surgery.
Setting
Accurate alignment of toric IOLs is critical for optimal astigmatism correction. Previous studies have suggested that image-guided digital marking systems (e.g., CALLISTO eye or VERION) provide better axis alignment than manual marking. This study evaluates the accuracy of toric IOL alignment using ARGOS-based digital marking compared with manual marking techniques.
Methods
This prospective randomized study included patients undergoing cataract surgery with pre-existing corneal astigmatism of 0.75 ~ 4.0 diopters. Patients were randomly assigned to either a digital marking group or a manual marking group. In the digital group, toric IOL alignment was guided using the ARGOS biometer integrated with a digital marker microscope system (VERION). In the manual group, the intended axis was marked at the slit lamp preoperatively and used for intraoperative alignment. Primary outcomes included axis misalignment at pre-op vs. post-op 1 month for both groups.. Secondary outcomes included uncorrected distance visual acuity (UCDVA) and residual refractive astigmatism at 1 month postoperatively.
Results
The results included 60 eyes (30 digital, 30 manual). Baseline demographic and preoperative characteristics were comparable between the two groups, including age, axial length, preoperative spherical equivalent, corneal astigmatism, and visual acuity (all p > 0.05). On postoperative day 1, mean axis misalignment was significantly lower in the digital group compared with the manual group (2.57 ± 2.86° vs. 4.38 ± 2.28°, p < 0.05). A similar difference was observed at postoperative day 30 (2.82 ± 2.37° vs. 4.45 ± 2.41°, p < 0.05). At 1 month, residual refractive astigmatism was −0.48 ± 0.28D in the digital group and −0.41 ± 0.23 D in the manual group, with no statistically significant difference (p = 0.261).
Conclusions
ARGOS-guided digital marking achieved more accurate toric IOL axis alignment than manual marking on post-op day 1 and day 30. However, short-term refractive outcomes were comparable between the two techniques.