Barberá Loustaunau, EmanuelBasanta, IvánVázquez, JoséDurán, PabloCosta, MaríaCouñago, Felipe M.D.Garzón Jiménez, NuriaSánchez, Miguel Ángel2023-06-172023-06-172021-04-260886-3350; 1873-4502 (e)https://hdl.handle.net/20.500.14352/8168Submitted: September 11, 2020; Final revision submitted: April 26, 2021; Accepted: April 26, 2021.Purpose: To compare the time spent on toric intraocular lens (IOL) implantation during cataract surgery using a manualmarking vs a digital image–guided system (the Verion) for toric IOL alignment. Settings: All procedures were performed at the Instituto Oftalmológico Quirónsalud ophthalmology clinic (A Coruña, Spain). Design: We designed an experimental and longitudinal (1-month follow-up) study. Methods: A total of 98 eyes of 65 participants (68.2 ± 12.2 years) were divided into 2 groups: 49 eyes operated with toric IOL alignment using a manual-marking technique (manual group) and another 49 eyes operated using image-guided marking (Verion group). The primary variable for comparison between both groups was cataract surgery time. Other outcomes such as toric IOL misalignment, spherical equivalent, astigmatism, uncorrected distance visual acuity, and corrected distance visual acuity were also measured. AU3 Results: The total cataract surgery time was 2:09 minutes shorter (P < .001) with the Verion system (12:12 ± 2:20) compared with the surgical procedure performed using manual marking (15:27 ± 3:04). One month after surgery, there were no statistical differences in terms of toric IOL misalignment between the Verion (3.38° ± 2.95°) and the manual group (4.66° ± 3.95°). No statistical differenceswere observed between groups for refractive and visual outcomes either (P ≥ .05). Conclusions: The cataract surgery time was reduced when the procedure was assisted using the Verion system to align the IOL compared with manual marking, maintaining the same efficacy in terms of toric IOL misalignment, residual refraction, and visual acuity.engAtribución-NoComercial-SinDerivadas 3.0 Españajournal articlehttp://www.lww.com/https://journals.lww.com/jcrs/pages/default.aspxopen access617.741‑004.1617.7‑089617.7‑089.243Oftalmología3201.09 Oftalmología