Correction of astigmatism at the time of cataract surgery

Abstract

Good uncorrected postoperative distance visual acuity can be obtained for a high percentage of cataract patients with preexisting corneal astigmatism. Postoperative keratorefractive surgery is available to enhance the condition of patients who achieve less-than-optimal astigmatic results.

Relationship between age, corneal astigmatism, and ocular dimensions with reference to astigmatism in eyes undergoing routine cataract surgery

“…7 In recent years, toric IOLs are increasingly used as firstline measures for correcting corneal astigmatism of 41.5 D at the time of phacoemulsification. 6,8 In this study, 44.2% of eyes had corneal astigmatism 41 D, which is higher than Chen et al 9 (41.3%), Ferrer-Blasco et al 10 (34.8%), Hoffman et al 11 (36.0%), and Khan et al 12 (40.41%). The higher figure in this study is likely to be concurrent to higher mean age of 72.28 years.…”

“…23 As 44.2% of this cohort have 41 D of astigmatism and toric IOLs are affective for treating 41 D of astigmatism at the time of surgery, this data is also useful to assess the necessity for use of toric IOLs in this population. 6 The data on prevalence of corneal astigmatism in our population is very useful for further design of local protocol and analysis of potential costs for the local NHS trust and NHS England. With reference to potential costs, an American study 23 concluded toric IOLs (where astigmatism 41.5 D) reduce lifetime economic costs by reducing the need for glasses or contact lenses, following cataract removal.…”

“…5 Toric IOLs are effective for treating 41 D of corneal astigmatism at the time of cataract surgery. 6 This study aims to identify any relationship between preexisting corneal astigmatism with age, axial length (AL), and anterior chamber depth (ACD) of the eyes undergoing preassessment for routine cataract surgery.…”

Comparison of Astigmatism Correction After On Axis Incision and an Additional Limbal Relaxing Incision During Phacoemulsification

“…5 Amesbury et al however said that "a PCRI depth of 450-550 microns is safe and effective, when used with a nomogram and pachymetry can be deferred in such cases." 6 In our study we used a steel blade set at a depth of 600 microns. Pachymetry was done for all patients.…”

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

“…This may be accomplished by first centering the incision on the steep corneal meridian (hence to be termed "on axis" technique) and then by varying its size and design, to affect a desired amount of wound flattening, and hence a decrease in cylinder. Such an approach, however, presents logistical challenges including movement around the surgical table, often producing awkward hand positions (12,(26)(27)(28) .…”