Toric intraocular lenses for correcting astigmatism in 130 eyes

Abstract

Myopia, hyperopia, and presbyopia are now fully correctable, with judicious selection of the IOL. Astigmatism, the irregular curvature of the corneal surface, remains, however, the single most common reason that patients require spectacle correction after cataract surgery. Large incision cataract surgery induced a large degree of postoperative astigmatism; today’s small, clear corneal cataract incision can create astigmatic neutrality. These same small incisions can also be fashioned to correct preexisting astigmatism at the time of cataract surgery. The surgical correction of astigmatism with corneal relaxing incisions, such as the arcuate kertotomy technique of Thornton, 1 Thornton S.P. Radial and Astigmatic Keratotomy. Slack, Thorofare, NJ1994 Google Scholar the keratolenticuloplasty technique that I have advanced, 2 Kershner R.M. Refractive Keratotomy for Cataract Surgery and Correction of Astigmatism. Slack, Thorofare, NJ1994 Google Scholar , 3 Kershner R.M. Keratolenticuloplasty arcuate keratotomy for cataract surgery and astigmatism. J Cataract Refract Surg. 1995; 21: 274-277 Abstract Full Text PDF PubMed Scopus (29) Google Scholar , 4 Kershner R.M. Clear corneal cataract surgery and the correction of myopia, hyperopia and astigmatism. Ophthalmology. 1997; 104: 381-389 Abstract Full Text PDF PubMed Scopus (43) Google Scholar , 5 Kershner R.M. Refractive cataract surgery. Curr Opin Ophthalmol. 1998; 9: 46-54 Crossref PubMed Scopus (14) Google Scholar and the limbal relaxing incision of Gills 6 Gills J.P. Optimizing vision with limbal relaxing incisions. Ophthalmol Management Oct. 1997; 1: 2 Google Scholar have all been recently popularized. Each has ability to alter corneal topography, flattening the steep corneal meridian and neutralizing preexisting astigmatism. Unfortunately, because of the technical and surgical skill involved, the need for diamond keratomes, and additional surgical instrumentation, many surgeons have not fully availed themselves of the advantages of astigmatic correction afforded by refractive keratotomy.