Eyeworld

Astigmatism Management When it comes to the target "sweet spot" for residual refractive astigmatism during the first few weeks following cataract surgery, 14% of re- spondents aim for 0.5 D or greater with-the-rule, and 33% aim for 0.3 D with-the-rule, while 20% aim for 0 D. I usually target 0.3–0.5 D. I was surprised at the "I do not have a 'sweet spot'" answer and was also surprised that almost 10% of people target against-the-rule astigma- tism. If you have all of your patients ending up between 0 and 0.5 D with-the-rule, those patients will do quite well overall. Responding to the level of total corneal astigmatism for them to consider implanting a toric IOL, 27% of respondents indicated 0.75 D, 34% answered 1.00 D, 13% indicated 1.25 D, 10% answered 1.50 D, and 2% said 1.75 D, with 14% responding that they don't implant toric IOLs. The modal number is 1 D, which is pretty good. In general, it shows the vast majority of respondents are using these effectively and using them for levels of astigmatism that are appropri- ate. What I was surprised with was the 14% who said, "I don't implant toric IOLs," and I wonder if those are young surgeons who haven't done a surgery yet. —Richard Tipperman, MD ASCRS Cataract Clinical Committee Chair pq Statistically significant difference between segments n=981 What is your target "sweet spot" for residual refractive astigmatism during the first few weeks following cataract surgery (in diopters)? "SWEET SPOT" BY SEGMENT % Practice location U.S. 71% International 74% Years in practice Early stage (0–5 years) 68% Mid-stage (6–10 years) 81% Late stage (11+ years) 78% Perform majority of surgeries in Hospital outpatient department 76% Office 77% Gender Male 76% Female 71% 14% 0.5 D or greater with-the-rule 33% 0.3 D with-the-rule 20% 0 D 4% 0.3 D against-the-rule 3% 0.5 D or greater against-the-rule 26% I do not have a "sweet spot" 74% of respondents have a target "sweet spot" for residual refractive astigmatism pq Statistically significant difference between segments n=981 At what level of total corneal astigmatism (in diopters) do you consider implanting a toric IOL? % IMPLANT & AVERAGE DIOPTERS BY SEGMENT IMPLANT AVERAGE Practice location U.S. 85% 1.59 D International 93% 1.54 D Years in practice Early stage (0–5 years) 80% 1.53 D Mid-stage (6–10 years) 93% 1.54 D Late stage (11+ years) 91% 1.61 D Perform majority of surgeries in Hospital outpatient department 96% 1.55 D Office 80% 1.49 D Gender Male 88% p 1.56 D Female 81% 1.64 D 27% 0.75 D 34% 1.00 D 13% 1.25 D 10% 1.50 D 2% 1.75 D 14% I do not implant toric IOLs 86% currently implant a toric IOL

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