I routinely take an iris photo of the patient at the fundus camera, print it and mark my axis. This is done weeks before the surgery at the biometry visit. Then that photo is used to orient me, enabling me to mark the corneal axis intra-operatively. It is VERY accurate and I have had great results. One caveat though, I dilate my cataract patients intra-operatively, so when I mark the cornea underthe microscope at the start of the case, the iris is constricted and all landmarks are visible. You can bill the patient for the photo, although I do it for free. Try it, it really works well!
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I routinely take an iris photo of the patient at the fundus camera, print it and mark my axis. This is done weeks before the surgery at the biometry visit. Then that photo is used to orient me, enabling me to mark the corneal axis intra-operatively. It is VERY accurate and I have had great results. One caveat though, I dilate my cataract patients intra-operatively, so when I mark the cornea underthe microscope at the start of the case, the iris is constricted and all landmarks are visible. You can bill the patient for the photo, although I do it for free. Try it, it really works well!