Digital marking versus manual marking technique for toric intraocular lens alignment: a meta-analysis

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Device Accuracy

Background:

• Cataract surgery frequently utilizes toric intraocular lenses (IOLs) to correct astigmatism.
• Accurate IOL alignment is crucial for achieving desired visual outcomes.
• Current alignment methods include manual marking and digital-assisted marking, with ongoing debate on their comparative accuracy.

Purpose of the Study:

• To conduct a meta-analysis comparing the accuracy of digital versus manual marking techniques for toric IOL alignment.
• To evaluate the impact of marking method on postoperative visual acuity and IOL misalignment.

Main Methods:

• A systematic literature search was performed across PubMed, Embase, and Cochrane Library.
• Included studies compared digital and manual marking for toric IOLs.
• Primary outcomes: uncorrected/corrected distance visual acuity, astigmatism deviation, and IOL misalignment.

Main Results:

• The meta-analysis included 7 studies (4 RCTs, 3 retrospective) with 197 eyes (digital) and 206 eyes (manual).
• No significant differences were found in postoperative uncorrected or corrected distance visual acuity between the groups.
• Digital marking demonstrated a statistically significant reduction in postoperative IOL misalignment (P=0.0001).

Conclusions:

• Digital marking techniques lead to significantly lower rates of postoperative IOL misalignment compared to manual marking.
• Both methods are effective, but digital marking is preferred for enhanced precision in toric IOL alignment.
• This finding supports the adoption of digital marking for improved accuracy in cataract surgery.