Step 3: Toric Procedure
Subtle procedural differences distinguish cataract surgery with a monofocal IOL from cataract surgery with a toric lens. These simply include: accounting for cyclorotation using reference marks, marking the steep axis and aligning the IOL once it is implanted.
Watch as Richard Tipperman,
MD,* walks through the eye marking process.
*Dr. Tipperman is a paid consultant for Alcon.
Marking Tools for Toric IOL Implantation Procedures
There are a variety of instruments designed to help mark the eye for successful toric IOL alignment and patient outcomes. Find a marker set you like best, and use it consistently.
Reference marking tools
The Bakewell Bubble Level† is a commonly used tool to make reference marks. This tool places peripheral marks along the horizontal meridian (00/1800)on each side of the cornea. This creates a linear reference for axis alignment of the lens.
Some surgeons prefer to mark the eye freehand with a fine-tip felt marker. While the patient is sitting up and looking straight ahead, the surgeon places a mark at 6 o’clock.
Axis marking tools
The Gimbel-Mendez Fixation Ring† is commonly used to mark the steep axis. This tool offers a two-handed technique for more control and visibility.