Time-efficiency assessment of guided toric intraocular lens cataract surgery: pilot study

J Cataract Refract Surg. 2021 Dec 1;47(12):1535-1541. doi: 10.1097/j.jcrs.0000000000000688.


Purpose: To compare the time spent on toric intraocular lens (IOL) implantation during cataract surgery using a manual-marking vs a digital image-guided system (t Verion) for toric IOL alignment.

Setting: Instituto Oftalmológico Quirónsalud ophthalmology clinic, A Coruña, Spain.

Design: Experimental and longitudinal study.

Methods: A total of 98 eyes of 65 participants (68.2 ± 12.2 years) were divided into 2 groups: 49 eyes operated with toric IOL alignment using a manual-marking technique (manual group) and another 49 eyes operated using image-guided marking (Verion group). The primary variable for comparison between both groups was cataract surgery time. Other outcomes such as toric IOL misalignment, spherical equivalent, astigmatism, uncorrected distance visual acuity, and corrected distance visual acuity were also measured.

Results: The total cataract surgery time was 2:09 minutes shorter (P < .001) with the Verion system (12:12 ± 2:20 in 49 eyes operated) compared with the surgical procedure performed using manual marking (15:27 ± 3:04 in 49 eyes operated). One month after surgery, there were no statistical differences in terms of toric IOL misalignment between the Verion (3.38 ± 2.95 degrees) and the manual group (4.66 ± 3.95 degrees). No statistical differences were observed between groups for refractive and visual outcomes (P ≥ .05).

Conclusions: The cataract surgery time was reduced when the procedure was assisted using the Verion system to align the IOL compared with manual marking, maintaining the same efficacy in terms of toric IOL misalignment, residual refraction, and visual acuity.

MeSH terms

  • Astigmatism* / surgery
  • Cataract*
  • Humans
  • Lens Implantation, Intraocular
  • Lenses, Intraocular*
  • Longitudinal Studies
  • Ophthalmology*
  • Phacoemulsification*
  • Pilot Projects
  • Refraction, Ocular