Combining Toric Lenses and Limbal Relaxing Incisions in Universal Lens Calculator for Cataract Surgery in Highly Astigmatic Patients

Tuesday, April 21, 2015: 9:16 AM
Room 5A (San Diego Convention Center)
Samir I. Sayegh, MD, PhD
David Hjelmstad
Stephan L. Leibbrandt

To describe methods to eliminate or maximally reduce the degree of astigmatism at the time of cataract surgery by appropriately combining available toric lenses and limbal relaxing incisions with any specified nomogram.

In a large population of patients astigmatic reduction via one intervention may be sufficient.  This population is identified and depends on a number of variables including the range of available toric IOLs.  Conditions under which a combination of techniques is necessary are identified.  Methods of combining toric lenses and LRIs are described and analyzed.  They are applied to 6 selected cases and used in the context of a universal intraocular lens calculator.

The methods presented yield a flexible algorithm to eliminate astigmatism for a variety of surgeon’s preferences and patients' pathology.  Near elimination of all astigmatism, and simultaneously attaining the required spherical target, is illustrated in all cases presented.

It is possible to eliminate or drastically reduce astigmatism in highly astigmatic patient in a flexible yet predictable way by appropriately combining toric lenses and LRIs.   A Universal Intraocular Calculator provides the robust adaptable and powerful algorithms required.