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Visual outcome of toric IOL implantation by the Verion image-guided system

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Session Details

Session Title: Pseudophakic IOLs: Toric Cataract Surgery Equipment

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 15:20

Venue: Room 1

First Author: : R.Dutta INDIA

Co Author(s): :    N. Shroff   A. Koul   G. Singh              

Abstract Details


To compare the outcome of Toric IOL implantation in patients with cataract and corneal astigmatism with the Verion Image Guided System vs the traditional method of preoperative and intraoperative reference marking.


Cataract and Intraocular Lens Implantation Service, Shroff Eye Centre, New Delhi, India.


52 eyes of 44 patients underwent pre-operative image capture with the Verion Reference Unit (Alcon) followed by Toric IOL implantation guided by projection of the implantation axis by the Verion Digital Marker in the microscope view. 42 eyes of 30 patients underwent pre-operative reference marking followed by intra-operative marking and Toric IOL implantatiopn. Residual astigmatism was noted at 1 and 3 months. Slit-lamp digital photographs were taken at 1 and 3 months and analyzed by Adobe Photoshop (version 7.0) by aligning a line through the axis marks of the Toric IOL. The amount of alignment error in degrees was noted.


Toric IOL models implanted were T3 to T8 (Acrysof IQ Toric). Mean UCVA was 0.14±0.18 in Verion group versus 0.26±0.20 in non-Verion group (p=0.003) at 1 month, and was 0.16±0.15 in Verion group versus 0.23±0.21 in non-Verion group (p=0.041) at 3 months. The residual cylinder (Diopters) was 0.52±0.36 and 0.77±48 at 1 month, and 0.58±0.47 and 0.79±0.65 at 3 months in the Verion and non-Verion groups respectively (p<0.001). The absolute alignment error at 1 week was 3.8±1.8 degrees in the Verion group versus 5.3±2.4 degrees in the non-Verion group (p=0.001). At 3 months, the absolute alignment error was 2.4±1.7 degrees (Verion) versus 4.0±2.5degrees (non-Verion) (p<0.001).


Accurate Toric IOL alignment is of utmost importance for getting the desired visual outcome. It is well known that 3 degrees of alignment error contributes to a 10% loss of astigmatic correction of a Toric IOL. Traditional reference marking, both pre- and intra-operative could contribute to a significant amount of misalignment. The Verion Image Guided System provides the surgeon real time guidance for IOL alignment with significant reduction of IOL misalignment and superior visual outcomes.

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