joja surgicals pvt. ltd. [email protected]
TRANSCRIPT
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Joja Surgicals Pvt. [email protected]
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This presentation is issued in scientific interest to promote better marking techniques for Toric IOL implantation, LRIs and refractive surgeries
The tool and software described in this presentation are patented / copyrighted
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This is not an advertisement
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Why is Marking Important?For every degree of rotation 3.3% of the effect is lostWith 30 degree rotation all effect of the Toric lens is lostBeyond that you start adding to the astigmatism
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Why is Marking Important?Higher the Toric correction greater the chances of errorse.g. For a 5 degree misalignmentIn a 6 D Toric error is 1 DIn a 1.5 D Toric error is 0.25 D
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So lets get the marking spot on !Two issues in markingMaking sure our 0 180 meridian is true horizontalMaking sure that the marks bisect the cornea through the optical centre
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Current MarkersHand held markersWith spirit level to ensure horizontality
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Current MarkersDo not ensure that the marks pass through the centre of the cornea
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Are you bisecting the cornea?
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Current MarkersYou also need a second intra-op mark if the placement axis is not 0 180
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Current MarkersCome in only one sizeBut the corneas are not of the same size or shape!
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IssuesStill does not solve the problem of bisecting the cornea through the optical centre
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A New ApproachA slit lamp based systemUses gravity to define horizontalUses Purkinje images to ensure centring on the cornea
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3 Simple StepsSet the slit lamp beam to the desired placement axisAlign the beam to pass through the corneal centre (described later)Mark the cornea
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Step 1 Setting the AngleThe slit beam can be set to the axis of placementNo need for reference markingClamp device to chin rest of slit lamp
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Setting the Angle
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Step 2Unclamp the calibrator devicePlace the patients head normally on the slit lamp
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Centring on the CorneaPatient looks at the light with the other eye closedMove the slit beam across the cornea until you get a bright Purkinje image
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Centring on the CorneaImages bordered in red show the correct positioning of the slit beam
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Centring on the Cornea
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How do we know it is accurate?
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Planiware 2.0This is a IOL planimetry software designed for measuringCentration of IOL, rhexis, pupilMeasurement of rhexis / pupil areas and diametersAngular measurements of Toric IOLs
Planiware can be downloaded from www.suryodaya.in/planiware
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Verifying your markings
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