A methodical approach is needed to identify the cause of and treatment options for refractive surprises after toric IOL implantation, according to OSN Cornea/External Disease Section Editor Elizabeth Yeu, MD.
There are various etiologies for refractive error surprises, according to Yeu. Wrong magnitude of total corneal astigmatism, induced or “false” corneal astigmatism due to dry eye disease or epithelial-based diseases, IOL power miscalculation, wrong effective lens position and malposition of the toric IOL can all contribute to unexpected results.
When observing and treating
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