Femtosecond laser, toric IOL used to treat high level of astigmatism

Quality of vision following surgery is the single most important factor that impacts patient satisfaction. Hence, the ophthalmic surgeon needs to deliver in order to meet patient expectations that have reached a new high compared with the past.Significant corneal astigmatism can degrade quality of vision and lead to patient dissatisfaction. It is important to identify and separate lenticular astigmatism from corneal astigmatism in the preoperative workup. Further, the surgeon has to consider both anterior and posterior corneal astigmatism when calculating toric IOL power. Because total corneal astigmatism is a combination of both anterior and posterior corneal astigmatism, total corneal astigmatism cannot be fully calculated purely by evaluating anterior corneal astigmatism and the related keratometric index. Posterior corneal astigmatism can contribute to about –0.3 D. With age, anterior corneal astigmatism moves from with-the-rule to against-the-rule astigmatism, while posterior corneal astigmatism usually exhibits against-the-rule astigmatism. The evaluation of both corneal surfaces will lead to a more accurate evaluation of total corneal astigmatism.