The purpose of this study was to evaluate an intraoperative marking technique using the body axis as a reference to allow intraoperative toric intraocular lens (IOL) alignment without preoperative corneal marking.
Forty eyes of 40 patients scheduled for cataract surgery were included in this study. In all cases, cataract surgery was performed as standard and a monofocal non-toric IOL was implanted. Intraoperatively, after draping, the horizontal corneal meridian was set perpendicular to the body axis, which was used as a reference axis, and blue ink was applied to mark the assumed 180° axis in supine position. Accuracy of the marking was assessed from standardized retroillumination photographs taken immediately after surgery in the sitting position.
Mean absolute deviation between the intraoperative marking and the assumed 180° horizontal meridian was 1.7° (SD: ±5.1°). Maximum deviation of the intraoperative marking was 16.2°.
Intraoperative marking using the body axis as a reference was on average reliable. However, significant misalignment was detected, so this method should be reserved for special cases in which preoperative marking is not feasible.