Clinical Ophthalmology (Feb 2019)
Novel method for preventing cyclorotation in Ziemer Femto LDV Z8 femtosecond laser-assisted cataract surgery with Verion image-guided system
Abstract
Hung-Yuan Lin,1–3 Ya-Jung Chuang,4 Pi-Jung Lin,5 Yi-Ju Ho6 1Universal Eye Center, Zhong-Li, Taiwan, Republic of China; 2Department of Optometry, Central Taiwan University of Science and Technology, Taichung City, Taiwan, Republic of China; 3Ophthalmology Department, Shanghai Ruidong Hospital, Shanghai, China; 4Universal Eye Center, Long-Tan, Taiwan, Republic of China; 5Universal Eye Center, Taipei, Taiwan, Republic of China; 6Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China Purpose: To investigate the feasibility of a new method involving the use of the Verion image-guided system in preventing cyclorotation during femtosecond laser-assisted cataract surgery (FLACS). Patients: Our preliminary data included details of 24 consecutive patients. All patients underwent cataract surgery at Universal Eye Center, Zhong-Li, Taiwan, between December 2016 and January 2017. Methods: We developed a technique to use the Verion image-guided system in FLACS and evaluated whether this new technique is compatible with Femto LDV Z8. The Verion image-guided system was used to prevent misalignments. The only additional step in this technique is using a marking tool to place ink on the corneal limbus (at 3 and 9 o’clock positions) guided by the Verion digital marker system. Remaining procedures could be performed using the touchscreen of Femto LDV Z8 to calibrate the horizontal reference axis. Results: This study included 24 patients who underwent cataract surgery. The technique used could effectively neutralize misalignments at an average of 8.08° and 2.66° in clockwise and counterclockwise directions, respectively. Conclusion: This technique combines the advantages of iris fingerprinting technology and mobile features of Femto LDV Z8, has fewer transfer steps, improves centration of the eyes, and, most importantly, can prevent misalignments through cyclotorsion or docking procedures. Furthermore, this method can improve the accuracy of arcuate incisions and toric intraocular lens alignment in astigmatism correction. Keywords: cyclotorsion, astigmatism, alignment, fingerprint technology, toric
