Every detail, digitally guided
Digitally planned, image-guided precision for every step of your cataract surgery. The Refractive Image Guidance System (RIGS) creates a surgical blueprint unique to your eye and tracks it in real time through the microscope.
A digital surgical plan, unique to your eye
The Refractive Image Guidance System (RIGS) is an advanced digital planning and intraoperative guidance platform that brings image-guided precision to every phase of cataract surgery. Before surgery, a high-resolution image of your eye captures unique anatomical landmarks—scleral vessels, iris patterns, limbus contours, and pupil characteristics—creating a detailed “fingerprint” that no two eyes share.
Your surgeon uses this fingerprint to build a customized surgical plan: precise incision locations calculated to minimize astigmatism, optimal IOL orientation for your specific corneal anatomy, and a step-by-step roadmap tailored to your visual goals. This digital plan then travels seamlessly from the clinic to the operating room, eliminating the manual data re-entry that can introduce transcription errors.
During surgery, the RIGS platform projects a real-time digital overlay directly into the operating microscope. This overlay tracks your eye continuously, automatically compensating for the natural rotation (cyclotorsion) that occurs when you move from sitting upright to lying down on the operating table. Your surgeon sees the planned incision axes, IOL alignment targets, and capsulorhexis guidance superimposed on a live view of your eye—turning a mental surgical plan into a visible, trackable guide.
The result is measurably more accurate incision placement, more precise IOL alignment (especially critical for toric and premium lenses), and a consistent, reproducible surgical approach that reduces the variability inherent in traditional manual techniques.
How RIGS guides your surgery
RIGS integrates three distinct phases into a single seamless workflow. Each phase builds on the last, so that by the time your surgeon begins operating, every critical decision has been digitally planned and verified.
- Image — Preoperative capture A high-resolution reference image of your eye is captured while you sit upright at the RIGS unit. The system simultaneously measures corneal curvature (keratometry) and pupil dimensions, and maps unique anatomical landmarks that serve as registration points during surgery. This non-invasive scan takes only a few moments and requires no dilation.
- Plan — Digital surgical blueprint Using the captured measurements and image data, your surgeon creates a fully customized surgical plan. The system calculates optimal corneal incision placement to reduce astigmatism, determines the ideal axis for toric IOL alignment, and maps the capsulotomy and IOL centration targets. Multiple IOL power calculation formulas are available within the platform, allowing your surgeon to cross-verify the best lens power for your eye.
- Guide — Intraoperative overlay In the operating room, the RIGS system projects the surgical plan as a real-time digital overlay into the operating microscope. As your eye is tracked continuously, the overlay automatically adjusts for any rotation or movement, ensuring that incision axes and IOL alignment markers remain precisely positioned throughout surgery. Your surgeon follows the digital guide to place incisions, centre the capsulorhexis, and align the IOL—all with image-guided verification rather than manual estimation.
Why it matters: Traditional cataract surgery relies on hand-drawn ink marks on the cornea to guide incision placement and IOL alignment. These marks are subject to smudging, migration, and parallax error. RIGS replaces ink with a continuously tracked digital overlay—a fundamentally more accurate and reproducible approach. Published studies demonstrate that image-guided alignment reduces toric IOL misalignment to approximately 1–3 degrees, compared with 3–5 degrees using manual marking techniques.
Why choose image guidance?
RIGS delivers measurable improvements in surgical accuracy and IOL performance. These advantages are most impactful when paired with premium intraocular lenses, where even small alignment errors can affect visual quality.
Precise IOL Alignment
Toric and multifocal lenses must be positioned at exact axis orientations to function correctly. RIGS provides real-time alignment tracking, helping your surgeon place the IOL within 1–3 degrees of the intended axis—significantly more accurate than manual ink-based techniques.
Cyclotorsion Compensation
When you lie down for surgery, your eyes naturally rotate (cyclotorsion). This rotation can shift the intended axis of a toric IOL. RIGS automatically detects and compensates for this rotation, maintaining the accuracy of the preoperative plan throughout the procedure.
Optimized Incision Placement
The system calculates and displays the ideal corneal incision location to minimize surgically induced astigmatism. Rather than relying on visual estimation, your surgeon places each incision at a digitally verified position based on your unique corneal topography.
Seamless Data Transfer
Your measurements, reference image, and surgical plan transfer electronically from the clinic to the operating room. This eliminates the manual re-entry of patient data between systems—removing a common source of transcription errors that can affect surgical accuracy.
Outcomes Tracking
RIGS maintains a database of postoperative results, allowing your surgical team to continuously refine their approach. This feedback loop supports the evidence-based, research-led methodology that underpins care at Uptown Eye Specialists.
RIGS and ReLACS: better together
RIGS and UltraView ReLACS are complementary technologies that address different aspects of cataract surgery. Understanding how they work together helps clarify the range of surgical technique options available to you.
ReLACS is a femtosecond laser that physically performs key surgical steps—creating blade-free corneal incisions, a perfectly circular capsulotomy, and pre-softening the cataract before extraction. It replaces manual cutting with laser precision.
RIGS is a digital planning and guidance overlay that provides your surgeon with a real-time visual map of the surgical plan during the procedure. It does not cut tissue—it ensures that every step, whether performed by laser or by hand, follows the precise digital plan calculated from your unique eye anatomy.
| Surgery Option | What It Includes | Best Suited For |
|---|---|---|
| Standard Cataract Surgery (CAT) | Manual incisions, manual capsulotomy, surgeon-guided IOL placement | Patients choosing OHIP-covered standard cataract surgery |
| CAT + RIGS | Manual surgery enhanced with image-guided digital planning and real-time IOL alignment overlay | Patients choosing toric or premium IOLs who want image-guided precision for lens alignment |
| ReLACS | Femtosecond laser incisions, capsulotomy, and lens softening for reduced tissue trauma and faster healing | Patients seeking laser precision for all surgical steps, with or without premium IOLs |
| ReLACS + RIGS | Laser-assisted surgery combined with image-guided digital planning and intraoperative guidance overlay | Patients choosing premium IOLs who want both laser precision and image-guided verification for maximum accuracy |
Which combination is right for you? Your surgeon will recommend the approach that best fits your visual goals, IOL selection, and eye anatomy during your consultation. Each option has clinical merit—there is no single “best” choice for every patient. Patients choosing toric or premium IOLs tend to benefit the most from RIGS, because precise alignment is essential for these lenses to deliver their full optical performance. Learn about the full cataract journey →
Is RIGS right for you?
RIGS can be added to any cataract surgery—whether standard manual or laser-assisted—but the clinical advantages are most significant for patients receiving premium intraocular lenses, where alignment precision directly affects visual quality.
RIGS provides the greatest value for patients who:
- Are choosing a toric IOL to correct astigmatism—where even a few degrees of misalignment reduces effectiveness
- Are choosing a multifocal, EDOF, or trifocal IOL—where centration and axis alignment affect the quality of vision at multiple distances
- Are receiving a Light Adjustable Lens (LAL) or other premium lens—where precision during initial placement sets the foundation for post-operative fine-tuning
- Have significant corneal astigmatism that requires precise incision placement for correction
- Want the added confidence of a digitally verified surgical plan tracked in real time through the microscope
- Are combining RIGS with UltraView ReLACS for the most comprehensive premium cataract experience
OHIP coverage: OHIP covers standard cataract surgery, including surgeon fees and a basic monofocal IOL. RIGS is a patient-paid technology upgrade that is not covered by provincial health insurance. Your surgeon will discuss all available options and associated considerations during your consultation.
Important context: Standard cataract surgery without RIGS is safe, well-established, and delivers excellent outcomes for the vast majority of patients. RIGS adds a layer of digital precision that is most clinically meaningful when premium IOL alignment is involved. Your surgeon will recommend whether RIGS is appropriate based on your specific eye anatomy, IOL selection, and visual goals. Explore all IOL options →
Guided by experience
Image-guided cataract surgery at Uptown Eye Specialists is performed by the same team that developed the UltraView ReLACS program—Canada’s highest-volume laser cataract centre, with over 3,000 published procedures. Their experience with advanced surgical technologies ensures that every RIGS-guided procedure benefits from deep expertise and continuously refined technique.
Dr. Hannah Chiu
MD, FRCSC
Brampton · Vaughan
Dr. Sangsu Han
MD, FRCSC
Brampton · Etobicoke · Vaughan · Scarborough
Dr. Kay Lam
MD, FRCSC
Brampton · Vaughan
Dr. Vincent Lam
OD, MD, FRCSC
Etobicoke · Vaughan · Scarborough
Dr. Raj Maini
MD, FRCSC
Brampton · Vaughan · Scarborough
Dr. Evan Michaelov
MD, FRCSC
Brampton · Etobicoke · Vaughan · Scarborough
Dr. Fariba Nazemi
MD, FRCSC
Brampton · Scarborough
Dr. Harrish Nithianandan
MD, FRCSC
Brampton · Etobicoke · Vaughan · Scarborough
Dr. Sohel Somani
MD, FRCSC, DABO
Brampton · Vaughan
Dr. Eric S. Tam
MD, FRCSC
Brampton · Etobicoke · Vaughan · Scarborough
Dr. Lili Tong
MD, FRCSC
Brampton · Etobicoke · Vaughan
Our full cataract surgical team also includes Dr. Kay Lam, Dr. Vincent Lam, Dr. Sangsu Han, Dr. Hannah Chiu, and Dr. Evan Michaelov — all Board-certified, hospital-credentialed surgeons with expertise in both traditional manual and image-guided cataract surgery.
Frequently asked questions
Ready to explore your options?
A comprehensive cataract evaluation will determine whether RIGS, ReLACS, or both align with your vision goals and IOL selection. You’ll receive detailed information about all available surgical approaches and what to expect.
The information presented on this website is educational only and not a substitute for professional medical advice. Surgical outcomes vary by patient anatomy, IOL selection, and surgeon experience. Consult your eye care provider to determine if RIGS is appropriate for you.