IC031 – TACKLING ASTIGMATISM DURING CATARACT SURGERY – DIFFERENT STROKES

Dr.Jai Gopal Agrawal [A05995] – Patna

It is not necessary to advise Toric IOL in astigmatism < +1.50Dcyl. Correction of astigmatism can be attained by selective positioning of incision with on-axis incisions , corneal relaxing incisions, LRIs and toric IOLs. Clear corneal OAI i.e. placing incision on steep meridian reduces astigmatism approximately by 1.0 D, depending on incision size and location of steep meridian. Opposite clear corneal incisions (OCCIs) offer another option for management. Here second opposite penetrating clear corneal incision is placed on the steep meridian 180 degrees away from the main incision, as depicted in corneal topography maps. OCCIs are predictable for enhancing the flattening effect on the cornea. OCCIs of 3.2 mm could provide a mean corneal astigmatism change of 1.60 to 2.25 D. Toric IOL implantation is for astigmatism > +1.25 Dcyl. Measurements by manual keratometry, topography, and automated keratometry and calculated by commonly used formula esp. Barrett toric calculator.