Correction of astigmatism at the time of cataract surgery

There are several options for correcting astigmatism at the time of cataract surgery. They include incision placement on the steep axis of corneal astigmatism, single or paired peripheral corneal relaxing incisions, and toric intraocular lens implantation. The aim of this review is to update readers on advances reported during the last year.

Phacoemulsification incision placement on the steep corneal axis corrects small amounts of astigmatism and is sufficient for most eyes. Peripheral corneal relaxing incisions correct greater amounts of astigmatism. They may be necessary when implanting multifocal intraocular lenses in eyes with more than 1 diopter of astigmatism. Toric intraocular lenses are also safe and effective for treating more than 1 diopter of astigmatism, and they now have excellent rotational stability.

Good uncorrected postoperative distance visual acuity can be obtained for a high percentage of cataract patients with preexisting corneal astigmatism. Postoperative keratorefractive surgery is available to enhance the condition of patients who achieve less-than-optimal astigmatic results.