Surgical correction of postoperative astigmatism

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• The photokeratoscope has advanced understanding of corneal asphericity and topography.
• This knowledge has driven the development of more predictable surgical astigmatic correction models.

Purpose of the Study:

• To review and discuss various surgical techniques for correcting astigmatism.
• To highlight the role of advanced imaging and surgical tools in astigmatism management.

Main Methods:

• Discussion of relaxing incisions, wedge resection, transverse incisions, semiradial incisions, and trapezoidal astigmatic keratotomy.
• Analysis of the predictability and limitations of each surgical method.
• Mention of the photokeratoscope and surgical keratometer as assessment tools.

Main Results:

• Relaxing incisions offer predictable spherical equivalent changes but have limitations in predictability.
• Wedge resection effectively corrects high postkeratoplasty astigmatism but involves prolonged recovery and potential for irregular astigmatism.
• Trapezoidal astigmatic keratotomy can correct significant diopters of astigmatism, with outcomes influenced by patient age.

Conclusions:

• Understanding corneal topography is crucial for effective surgical astigmatism correction.
• Different surgical techniques offer varying degrees of correction and possess distinct limitations.
• Advanced tools like the surgical keratometer aid in achieving optimal surgical outcomes.