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Comparison of two different manual corneal marking techniques for toric iol alignment

Poster Details

First Author: C.Ganapati INDIA

Co Author(s):    K. Kudlu   H. Shetty   V. Jain              

Abstract Details


To compare the clinical outcome of two different methods of manual marking for toric intraocular lens (IOL) alignment


Prasad Netralaya Super Speciality Eye Hospital


This is a prospective clinical study that included 50 eyes of 44 patients undergoing cataract surgery with coexisting corneal astigmatism more than 1 diopter (D). The eyes were randomly assigned to either Slit lamp marking using the slit-lamp that allows measurement of the angle in which the slit beam is rotated or manual marking using the bubble marker and optimising it with the smart phone gyroscope app (iToric android app). Carl Zeiss AT Torbi 709M IOL was implanted in all cases.


The mean postoperative uncorrected distance visual acuity (UCDVA) for the Slit lamp group was 0.18 + 0.14 logMAR, and for the manual-marking group was 0.12 + 0.12 log MAR (P = 0.104). The mean deviation from targeted induced astigmatism (TIA) for the first group was 0.20 + 0.14 D and for the second group was 0.10 + 0.08 D (P = 0.001). The mean postoperative toric IOL misalignment measured by the slitlamp was 4.33° + 2.72° for the first group and was 2.4° + 1.96° for the second group (P = 0.003)


Accurate alignment of the toric IOL is important to achieve the desired astigmatism correction. Manual marking with smart phone optimisation has the advantage of preoperative planning and intraoperative digital guidance of the toric IOL alignment. The use of smartphone gyroscope app system resulted in less postoperative deviation from TIA and showed less postoperative toric IOL misalignment than using slit lamp marking technique

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