The Cionni Toric Reference Marker (ref: 9-840) is used to mark the horizontal and vertical reference meridians. It is imperative to identify these meridians because they will be used to further identify the desired meridians for the incision and IOL alignment. The reference marks should be identified with the patient in an upright position as the eye typically rotates when the patient is supine. After applying a drop of topical anesthetic, the marker's dull "blades" are coated with a marking pen. With the patient looking straight ahead, the marker is held so that the horizontal blades are aligned with the patient's 0 and 180 meridians. The marker is moved forward towards the eye so that the three blades touch the limbus at 0, 90 and 180 degrees. The patient is then prepped for surgery.

Marking the incisional and desired axis of IOL alignment can be accomplished using the Cionni Toric Axis Marker (ref:9-841). The line on the top portion of the marker is rotated to set the blades to the desired meridian for the incision or IOL axis. The two blades on the underside of the Axis Marker are then coated with a marking pen and the limbus dried with a sponge. The Axis Marker is then positioned over the eye, lining up the holes at the horizontal and vertical meridians with the previously made limbal reference marks. The Axis Marker is then lowered to touch the eye so that the blades make the desired marks on the limbus.