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    Intraoperative Determination of IOL Centration with Purkinje Images

    By Daniel Chang, MD
    Annual Meeting 2011
    Cataract/Anterior Segment

    Good centration of presbyopic IOLs is needed to maximize visual function and to minimize negative visual symptoms. On a diffractive multifocal IOL, one can clearly see the center of the IOL and its relationship to the center of the pupil. However, finding the center of the undilated pupil while working on a dilated eye intraoperatively can be a challenge. This video introduces a novel technique that uses the 3 Purkinje images to locate the center of the scotopic or photopic pupil, as well as the visual axis, while operating on a dilated eye. This technique is simple, reproducible, accounts for fixation, eliminates parallax, and requires no marking, miotics, or additional instrumentation.