Purpose: To compare the clinical outcomes of 3 marking methods for toric intraocular lens (IOL) implantation in cataract patients. Methods: This study included 48 eyes of 48 cataract patients who underwent cataract surgery with toric IOL implantation. The rotational errors of 3 marking methods—the iris pattern marking method (iris pattern group), the pendulum marking method (pendulum group), and the 3-point marking method (3-point group)—were assessed. Results: The respective rotational errors were 4.0° ± 3.1° (mean ± SD), 5.3° ± 4.1°, and 7.3° ± 6.0°. The iris pattern group had significantly (P = 0.048) smaller rotational errors than did the 3-point group; no significant difference was found between the iris pattern and pendulum groups. However, the differences in postoperative uncorrected distance visual acuity and astigmatism did not reach significance among the 3 groups. Conclusion: The refractive and visual results of toric IOL implantation using the 3-point marking method were comparable to the other methods evaluated in this study, although the accuracy of the axis alignment of the toric IOLs was significantly lower than that obtained with the iris pattern method.
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