Effect Of Different Toric Intraocular Lens Marking Methods On Postoperative Visual Effects

Objectives The study aims to mark the astigmatism axis of patients with different methods through femtosecond laser-assisted cataract phacoemulsification combined with astigmatic correction Toric Intraocular Lens(Toric IOL)implantation,and to research the difference in accuracy and postoperative rotational stability with different labeling methods by comparing direct vision manual labeling,labeling guided by Callisto eye navigator and LensAR femtosecond laser system capsule labeling guided by Pentacam anterior segment panoramic analyzer.Methods From July 2018 to November 2019,53 patients(60 eyes)underwent femtosecond laser-assisted cataract phacoemulsification combined with Acrysof IQ Toric IOL implantation in Tangshan Eye Hospital.All patients underwent detailed preoperative examination.The patients were divided into manual labeling group,navigator labeling group and capsular labeling group according to the randomized controlled table,and respectively underwent Femtosecond laser-assisted cataract phacoemulsification combined with Toric IOL implantation.Patients were followed up one day,one week,one month and three months after surgery.The uncorrected visual acuity(UCVA),residual astigmatism,anterior chamber depth(ACD),best corrected visual acuity(BCVA),Icare measurement of intraocular pressure,observation and taking photos with digital camera of Toric IOL axial position under slit lamp after mydriasis,Scheimpflug image taken by Pentacam,image measurement with Image Pro Plus software and calculation of Toric IOL postoperative tilt angle and eccentric value were carried out.Results UCVA and BCVA at different time points after operation in the three groups were significantly different from those before operation(P<0.05).Compared with BCVA among the three groups,there were statistically significant differences between navigator group and manual group one month after operation,capsule group and manual group three months after operation,navigator group and manual group three months after operation(P<0.05).Compared with the residual astigmatism at different time points after operation among the three groups,the difference between the capsule group and the manual group,navigator group and manual group at one month and three months after operation is statistically significant(P<0.05).There were statistically significant differences in the degree of axial deviation among the three groups(P<0.05).The groups were respectively:capsule group and manual group one week after operation,capsule group and manual group one month after operation,navigator group and manual group one month after operation,capsule group and manual group three months after operation,navigator group and manual group three months after operation.The difference in average tilt angle among the three groups is statistically significant(P <0.05).The groups are respectively:capsule group and manual group one week after operation,navigator group and manual group one week after operation,capsule group and manual group one month after operation,navigator group and manual group one month after operation,capsule group and manual group three months after operation,navigator group and manual group three months after operation.The difference of average eccentric value among the three groups was statistically significant(P<0.05).The groups were respectively:capsule group and manual group,navigator group and manual group one week after operation,capsule group and manual group,navigator group and manual group one month after operation,capsule group and manual group three months after operation.The correlation between inclination angle and eccentricity value at each time point after operation is as follows:there is no correlation between inclination angle and eccentricity value at 90 and 180 at each time point after operation in capsular group(P>0.05);In the navigator group,there were correlations:90 azimuth one week after operation,90 and 180 azimuth one month after operation,90 and 180 azimuth three months after operation(P<0.05);The correlation existed in manual group,180 orientation one month after operation,90 and 180 orientation three months after operation(P<0.05).Conclusions Both femtosecond laser-assisted capsule marking and navigation-guided corneal marking methods can effectively improve the accuracy of Toric IOL’s axial positioning.Both methods have advantages in reducing IOL axial deviation,postoperative residual astigmatism,tilt angle and eccentric value.The femtosecond laser-assisted capsular marking method is more objective than the navigation-guided corneal marking method because it reduces the spatial error,and is worth recommending.Figure17;Table9;Reference 151...