Chirurgische Astigmatismuskorrektur bei der Kataraktoperation

Abstract

To enhance patients' postoperative optical quality after cataract surgery, among others, different procedures to correct corneal astigmatism are used. An overview is presented on procedures to correct astigmatism during cataract surgery, based on a selective literature review and the authors" own experience. Described are incisional techniques to change the corneal curvature as well as the implantation of toric posterior chamber intraocular lenses (IOL) after phacoemulsification. Further on patient selection and indications of the different methods are illustrated. In particular, limbal relaxing incisions provide satisfying results in astigmatism correction of up to 2 diopters, if published and surgeons individual nomograms are used. Larger astigmatism of up to about 30 diopters may be corrected with toric IOL. Compared to incisional techniques, those toric implants provide better predictability and precision and suffer less from regression. Usually the focus of cataract surgery is the correction of aphakia. Today's techniques and implants, however, offer surgeons the chance to individualize patients postoperative astigmatism and thus increase overall patient satisfaction.