Different approaches available to determine axis of astigmatism for toric implants

Correcting astigmatism at the time of cataract surgery provides patients with improved vision; toric IOLs are an excellent option for patients with greater than 1 D of symmetric astigmatism. However, the implant must be properly aligned to provide the desired outcome. As cataract surgeons, we measure our patients in a myriad of ways — manual keratometry, optical biometry, intraoperative aberrometry, wavefront topography — but which measurement do we use as our final pick to align the toric implant? Below are comments from multiple surgeons describing their preferred approaches.

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