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Evaluation of a software-based workplace environment for digital-assisted toric intraocular lens implantation

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First Author: W.Mayer GERMANY

Co Author(s):    M. Ramsauer   S. Vounotrypidis   N. Luft   S. Priglinger   M. Shajari        

Abstract Details


To evaluate efficacy and efficiency of a digital-assisted calculation and planning system (EQ workplace, Zeiss Forum®) for toric intraocular lenses (IOLs) in comparison to a manual workflow.


University Eye Hospital Munich, Germany


This study included patients having cataract surgery with implantation of a toric IOL (Zeiss Torbi 709M or LARA Toric). They were randomly assigned to 1 of 2 groups based on the marking system used, manual or digital. Patients were included if they had age-related cataract and a regular corneal astigmatism of 1.0 diopters (D) or higher. Visual and refractive outcomes as well as rotational stability were evaluated. Vector analysis was performed to evaluate total astigmatic changes.


The study comprised 68 eyes of 34 patients; there were 32 eyes in the manual group and 36 eyes in the digital group. The mean toric IOL misalignment was significantly lower in the digital group than in the manual group (2.3 degrees +/- 1.87 [SD] versus 3.7 G +/- 2.41 degrees; P = 0.026). The mean deviation from the target induced astigmatism was significantly lower in the digital group (0.20 +/- 0.12 D versus 0.36 +/- 0.16 D; P = 0.008). During surgery, the mean toric IOL alignment time was significantly shorter in the digital group (25.4 +/- 10.4 seconds versus 57.4 +/- 18.3 seconds; P = 0.003). The time required to perform pre-operative planning and calculation and data export of IOLs was significant faster when using a software-based platform (EQ workplace). Furthermore, overall surgery time was significantly shorter in the digital group (898.2 + 175.4 seconds versus 1405.0 +/- 285.2 seconds; P < 0.001).


A digital planning and tracking approach for toric IOL implantation was efficient and safe to improve refractive outcomes. Furthermore, image-guided surgery helped to streamline the workflow in refractive cataract surgery.

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