<p>Consensus on the management of astigmatism in cataract surgery</p>

Abstract

This project was aimed at achieving consensus on the management of astigmatism during cataract surgery by ophthalmologists from Latin America using modified Delphi technique. Relevant peer-reviewed literature was identified, and 21 clinical research questions associated with the definition, classification, measurement, and treatment of astigmatism during cataract surgery were formulated. Twenty participants were divided into seven groups, and each group was assigned three questions to which they had to respond in written form, after thoroughly reviewing the literature. The assigned questions with corresponding responses by each group were discussed with other participants in round 4 – presentation of findings. The consensus was achieved if approval was obtained from at least 80% of participants. The present paper provides several agreements and recommendations for management of astigmatism during cataract surgery, which could potentially minimize the variability in practice patterns and help ophthalmologists adopt optimal practices for cataract patients with astigmatism and improve patient satisfaction.

Clinical evaluation of toric intraocular lens implantation based on iTrace wavefront keratometric astigmatism

“…Factors influencing residual refractive astigmatism after cataract surgery with toric IOLs include accurate preoperative corneal astigmatism measurements, variability in the magnitude and direction of corneal incision SIA, the effects of different toric calculators, the rotational stability of different toric IOLs [8], and reported lens tilt [9]. Several diagnostic devices based on different technologies are available to measure preoperative corneal power and astigmatism, including manual and automated keratometers; Placido-based corneal, point-source color light emitting diode, Scheimpflug image-based, and scanning-slit corneal topographers; low-coherence reflectometers; and intraoperative aberrometers [10][11][12][13]. However, none of these methods are currently considered the gold standard.…”

<p>Impact of Thermal Pulsation Treatment on Astigmatism Management and Outcomes in Meibomian Gland Dysfunction Patients Undergoing Cataract Surgery</p>

“…7,8 The unstable tear film affects the quality of optical surface reflections from the cornea on which the keratometric measurements are based, compromising keratometry readings with manual keratometry or advanced devices like placido disc/point-source color light-emitting diode topographers, slit-scan imaging, swept source OCT biometers or Scheimpflug image-based tomographers. 9,10 Further, chronic ocular desiccation and deficiency of the tears have also been associated with corneal deformation, most commonly inferior corneal steepening and high astigmatism resembling keratoconus. 11 This could potentially be due to dry eye-induced, prolonged inflammation or eye rubbing or other unknown mechanisms.…”

Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

“…Factors in uencing residual refractive astigmatism after cataract surgery with toric IOLs include accurate preoperative corneal astigmatism measurements, variability in the magnitude and direc tion of corneal incision SIA, the effects of dif ferent toric calculators, the rotational stability of different toric IOLs [8], and reported lens tilt [9]. Several diagnostic devices based on different technologies are available to measure preoperative corneal power and astigmatism, including manual and automated keratometers; Placidobased corneal, point-source color light emitting diode, Scheimp ug image-based, and scanning-slit corneal topographers; low-coherence re ectometers; and intraoperative aberrometers [10][11][12][13]. However, none of these methods are currently considered the gold standard.…”