Objective:

The objective of the study is to compare the functional and visual results of patients after implantation of toric intraocular lens during cataract surgery using manual marking versus digital marking for intraoperative guidance.

Methods:

Participants (100 patients, 120 eyes) with cataract and corneal astigmatism of 1.00 D-5.00 D were included in our study. They were categorized into two different groups. The first group (52 patients, 60 eyes) was manual marking group #1, and the second group (48 patients, 60 eyes) was digital marking group #2. During the preoperative period, the uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and corneal astigmatism were assessed. Using Barette toric calculator, both the IOL power and axis alignment were measured. The marking of the eyes was performed with bubble marker and Mendez ring in group #1 while the VERION system (Alcon, Fort Worth, TX, United States) was used in group #2. The UDVA, CDVA, residual refractive cylinder, and IOL misalignment were all measured (I trace system, Tracey technologies, Houston, TX, United States) at 1, 3, and 6 months.

Results:

The mean postoperative cylindrical error was 0.4 ± 0.32 D in group #1, and 0.22 ± 0.29 in group #2 (p = 0.03). At 6 months, postoperatively, residual astigmatism of > 0.5 D and ≥ 1.0 D was achieved in 70% (42 eyes, 40 patients) and 81.6% (49 eyes,48 patients) of the patients from the group #1 compared to > 0.5 D and >1.0 D in 68.3% (41 eyes,40 patients) and 96.6% (58 eyes, 47 patients) of the patients from group #2. Toric IOL misalignment was 4.4 + −2.12° in group #1 compared to 3.7 + −2.3° in group #2 (p = 0.38).

Conclusion:

Both marking methods proved nearly equally effective for the guidance of toric IOL alignment being digital marking more accurate.

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