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Marker device may eliminate need for preop marks in toric IOL implantation
The device was designed to reduce the opportunity for error when marking for toric IOLs.
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 Tobias H. Neuhann |
With the implantation of toric IOLs gaining popularity throughout the world, physicians are looking for simple and accurate ways to make toric marks that complement their technique.
The physician’s simple goal is to perform a safe and accurate procedure to achieve maximum visual acuity for the patient. For every degree of misalignment, a toric lens will lose 3% of its corrective effect, so an accurate toric mark is essential for a toric surgery. Traditional toric methods use a three-step technique, first using the alignment marker to make the preoperative markings at the horizontal axis from 0° to 90°; then indicating 30°, 60° and 90° with the degree gauge; and finally, using a third instrument, the toric IOL marker, to create the intraoperative markings.
Precise alignment of the toric marker is necessary to maximize the corrective effect of the toric lens. Each step in toric marking presents an additional opportunity for error. With perfect vision being the ultimate goal, physicians are looking for ways to reduce these errors.
Marker’s design
In conjunction with Tobias H. Neuhann, MD, ASICO designed the Neuhann Toric Marker, which was launched in October 2010. This marker is designed to enable the ordinarily intraoperative toric marks to be made preoperatively, and it eliminates the need for preoperative horizontal axis marking.
The marker’s concept is simple: reduce the steps and reduce the opportunity for error. Dr. Neuhann designed the marker specifically for fast, simple and reliable marking.
There is frequently an issue with error in degree markings. The marker’s design helps address this concern, and the device is equipped with a bubble level that detects the slightest change of movement to prevent incorrect marking. The sensitivity of the bubble level is less than 0.5°, providing for precise alignment. The level can be removed easily before sterilization and can be cleaned either with an alcohol wipe or simple soap-and-water solution. The titanium body of the instrument can be sterilized according to guidelines. To help with accurate toric marking placement, the handle shows a 0°/180° pattern, with degree markings every 5°.
Marker’s use
Another concern with toric marking is that the marks will not last long enough. With the Neuhann Toric Marker, the surgeon can mark at the slit lamp with or without a marking pen because the indentation from the marks will last sufficiently in the epithelium. The new analog marker is as precise as the new digital systems, but with less preoperative effort required and a lower cost.
Because patients’ orbits come in different shapes and sizes, Dr. Neuhann wanted to create a marker that could be used in all cases. The marker has an outer diameter of 12.5 mm and can be used on any patient, including those with smaller orbits. There is a wide center opening for increased visibility and centering cornea light reflex. The outer knurled barrel allows for easy axis rotation and accurate alignment of the IOL placement axis. Lines on the marker serve as a guide for the axis marking pattern.
In moving toward efficiency, the Neuhann Toric Marker addresses the concerns that come with toric marking, particularly degree marking error, marking duration and patient orbit size.
For more information:
Andrew Burns can be reached at andrew@asico.com.
Tobias H. Neuhann, MD, can be reached at AAM Augenklinik, AM Marienplatz 18/19, Munich, Germany 80331; +49-89-2308890; fax: +49-89-2308898; email: tneuhann@web.de.
Disclosure: Mr. Burns is an employee of ASICO, which sells the Neuhann Toric Marker. Dr. Neuhann created the device.