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I describe an intraoperative method for the consistent anchoring of the intraocular lens (IOL) and cataract surgery and on the patient's visual axis using coaxial microscope optics, surgeon-guided patient fixation, the precision pulse capsulotomy (PPC) device (Zepto) and utilizing the first (and fourth) Purkinje images. During surgery using a microscope with coaxial lights and optics, the patient is instructed to fixate on a given microscope light while the surgeon looks through the corresponding coaxial eyepiece. Then, the PPC device is centered on the Purkinje I image and a capsulotomy is performed. The resulting capsulotomy serves as a reference marker for the visual axis and IOL placement, with even capsule overlap, which results in IOL centration on this axis landmark. This method might help address the high variability in angle κ from patient to patient and provide visual benefits in cases of implantation of multifocal IOLs and other IOLs.

Streamlined method for anchoring cataract surgery and intraocular lens centration on the patient’s visual axis