October 2018


Revisiting astigmatism

Rosa Braga-Mele, MD,
Cataract editor

Ophthalmology is an incredibly evolving field of medicine with respect to diagnostics and treatments from the cornea to the retina. When performing cataract surgery, we not only need to keep in mind all of the new technology to perform cataract surgery itself, but also all the adjuvant technology and equipment to optimize refractive and overall visual outcomes. It is truly an exciting time for ophthalmologists and their patients, and we have to continually revisit techniques and technology to make sure we are current and up to date. As such, in this issue of EyeWorld, we revisit astigmatism and all the new diagnostics, technologies, and treatment modalities available to help us diagnose and treat astigmatism to optimize our patients’ visual outcomes.
We often question how to truly measure astigmatism most effectively. Kendall Donaldson, MD, Preeya Gupta, MD, Vance Thompson, MD, and Tal Raviv, MD, eloquently guide us through the latest available technology and devices and how to use the measurements effectively. They also help us understand the best calculations to use. However, they do warn us to remember and respect the ocular surface when proceeding.
We learn from some of our colleagues different ways to correct corneal astigmatism. Michael Greenwood, MD, Brandon Baartman, MD, Elizabeth Yeu, MD, and Kevin Miller, MD, reflect on determining and correcting total corneal astigmatism. They delve into the different treatment modalities such as toric IOLs and LRIs and femto AKs and the accuracy and advantages of each.
We then hear about the current views on AKs from Uday Devgan, MD, and Eric Donnenfeld, MD, specifically about classic AK and femto AK and the differences in treatment. They review the amounts to treat and any specific issues with respect to regression.
The experts on IOL calculations and posterior corneal astigmatism, Douglas Koch, MD, and Warren Hill, MD, help us understand posterior corneal astigmatism for toric IOL implantation. They review pearls for measurements and technology available but also stress that we need to remember to calculate the anterior corneal astigmatism accurately as well.
Finally, we visit astigmatism and how it pertains to presbyopia correcting IOLs. Michael Patterson, DO, Tal Raviv, MD, and Richard Lindstrom, MD, guide us through the amount of astigmatism that will be tolerated and thus need to be treated with these specialty IOLs. They also enlighten us on the use of corneal surface treatment of astigmatism versus some of the IOLs with a toric component.
This is an action packed and educational issue on astigmatism, which is sometimes still a bit of a challenge in calculating and treating. I know that this issue will aid me in making informative decisions in the care of my patients with respect to astigmatism correction, and I hope you will find it as illuminating as I do.

Revisiting astigmatism Revisiting astigmatism
Ophthalmology News - EyeWorld Magazine
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