PUBLICATION EXCLUSIVE: Increase accuracy of preop measurements with ‘markerless’ toric IOL alignment techniques

Refractive cataract surgery continues to gain in popularity among both cataract surgeons and their patients because advanced technology and surgical techniques seem to deliver improved visual outcomes. Among cataract surgery patients, corneal astigmatism of greater than 1 D was noted in 40% of eyes in a U.K. study and 50% of eyes in an Italian study, greater than 1.25 D in 27.5% of eyes in a Chinese study, and greater than 2 D in 8% of eyes in a German study.Optimal optical visual quality is bestowed by attaining uncorrected emmetropia or corrected emmetropia that includes sphere, cylinder, or both sphere and cylinder. With the insertion of an intraocular prosthetic device such as the standard IOL, the spherical correction can be greatly improved toward emmetropia, utilizing preoperative testing devices such as the IOLMaster (Carl Zeiss Meditec), Lenstar (Haag-Streit) and AL-Scan optical biometer (Nidek). This surgical approach serves well for patients with preoperative spherical correction, while those with astigmatism are treated with limbal relaxing incisions and/or postoperative spectacle or contact lens correction.