Iris Registration Capsulotomy Marking Versus Manual Marking for Toric Intraocular Lens Alignment in Cataract Surgery

Purpose To compare the accuracy of toric intraocular lens (IOL) alignment and visual outcomes using femtosecond laser–assisted capsulotomy marking (CM) versus conventional slit lamp−assisted manual marking (MM). Design Prospective cohort study. Methods A total of 57 patients who required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T8) were assigned to the CM group (26 eyes) or the MM group (31 eyes). Uncorrected distant visual acuity (UCDVA), best-corrected distant visual acuity (BCDVA), residual astigmatism (RA), IOL misalignment, and modulation transfer function (area ratio [AR] value) were measured 1 and 3 months after surgery. Results Postoperative UCDVA (logarithm of minimal angle of resolution [logMAR]) was significantly lower in the CM group than that in the MM group (P < .05). Postoperative RA and IOL misalignment were significantly lower in the CM group than that in the MM group (both P < .05). No significant difference between the groups was observed for BCDVA or AR value (both P > .05). UCDVA (logMAR) was positively correlated with RA (r = 0.339; P < .05) and IOL misalignment (r = 0.317; P < .05) and negatively correlated with the the AR value (r = −0.272; P < .05); RA was positively correlated with IOL misalignment (r = 0.405; P < .05). Conclusions The accuracy of the axis alignment was significantly higher in the CM group, which resulted in lower residual astigmatism and better visual outcomes. To compare the accuracy of toric intraocular lens (IOL) alignment and visual outcomes using femtosecond laser–assisted capsulotomy marking (CM) versus conventional slit lamp−assisted manual marking (MM). Prospective cohort study. A total of 57 patients who required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T8) were assigned to the CM group (26 eyes) or the MM group (31 eyes). Uncorrected distant visual acuity (UCDVA), best-corrected distant visual acuity (BCDVA), residual astigmatism (RA), IOL misalignment, and modulation transfer function (area ratio [AR] value) were measured 1 and 3 months after surgery. Postoperative UCDVA (logarithm of minimal angle of resolution [logMAR]) was significantly lower in the CM group than that in the MM group (P < .05). Postoperative RA and IOL misalignment were significantly lower in the CM group than that in the MM group (both P < .05). No significant difference between the groups was observed for BCDVA or AR value (both P > .05). UCDVA (logMAR) was positively correlated with RA (r = 0.339; P < .05) and IOL misalignment (r = 0.317; P < .05) and negatively correlated with the the AR value (r = −0.272; P < .05); RA was positively correlated with IOL misalignment (r = 0.405; P < .05). The accuracy of the axis alignment was significantly higher in the CM group, which resulted in lower residual astigmatism and better visual outcomes.