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Abstract
Purpose
To compare the efficacy of digital-assisted reference marking for toric implantable collamer lenses (Callisto Eye System) with manual marking technique using a slit lamp markeur.
Methods
This study included patients that underwent implantation of a toric implantable collamer lens (EVO Visian toric ICL, Staar Surgical). Patients were included if they had a myopia above −3 diopters (D) and regular corneal astigmatism of 0.75 diopters or higher. Between both groups a 1:2 matching regarding similar preoperative level of myopia and astigmatism was performed. Visual and refractive outcomes were evaluated. Vector analysis was performed to evaluate total astigmatic changes.
Results
This study comprised 57 eyes of 57 patients with 19 eyes in the digital group and 38 eyes in the manual marking group. Postoperatively there were no statistically significant differences between both groups in UDVA (p = 0.467), spherical equivalent (SE) (p = 0.864), sphere (p = 0.761) and cylinder (p = 0.878). Vector analysis showed a slightly more accurate postoperative refractive astigmatism in the manual group (0.26 D at 107° ± 0.50 D) compared to the digital marking group (0.31 D at 107° ± 0.45 D), nevertheless with no statistically significant differences between both groups.
Conclusions
A digital tracking approach for toric ICL alignment was an efficient and safe method for toric marking with similar results regarding visual and refractive outcomes compared to a conventional corneal marking method. Nevertheless, image-guided surgery helped to streamline the workflow in refractive ICL surgery.
Disclosure statement
N. Luft: Carl Zeiss Meditec AG: Lecture honoraria. W.J. Mayer: Carl Zeiss Meditec AG: Financial Support, Consultant, Recipient; Staar Surgical: Recipient. M. Dirisamer: Carl Zeiss Meditec AG: Lecture honoraria, Travel expanses. All other authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Data availability statement
The raw dataset analyzed in this study are not public due to personal privacy but are available from the corresponding author, [LF], upon reasonable request.
Standards of reporting
The 9 Standard Graphs for Reporting Refractive Surgery Results as required by the JCRS were used. The Excel tool for creating these standard graphs is available at: https://www.londonvisionclinic.com/refractivesurgeryoutcomes/