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Use of digital marking for toric intraocular lenses in a patient with cyclodeviation

Poster Details

First Author: R.Seif LEBANON

Co Author(s):    J. Bleik   N. Jabbur                 

Abstract Details


To report the use of VERION Image Guided System for accurate toric IOL alignment in a case of superior oblique palsy (SOP).


Lebanese American University Medical School


A 70-year-old male presenting with blurred vision, diplopia and head tilt was found to have right superior oblique palsy, bilateral visually significant nuclear sclerosis and moderate corneal astigmatism. His workup was negative. We explained to the patient that his binocular diplopia is probably caused by a decompensated SOP, and that the expected improvement in vision after cataract and toric IOL surgery may help him regain single binocular vision.We elected to proceed with sequential cataract surgery with toric IOL implantation using the preoperative and intraoperative help of the VERION Image Guided System.


The patient was satisfied and had improved visual acuity including refractive astigmatism as well as no complaints of double vision.


Patients with cyclodeviations present a challenge for manual pre-op marking because of compensatory head tilt and the variation of the axis of astigmatism between monocular and binocular conditions.In such patients, digital marking for toric IOL implantation is particularly a valuable tool. Also, the improvement of visual acuity after cataract surgery assists in reversing sensory deprivation and helps the patient regain a clear visual axis to restore functional fusional amplitudes.

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