Eyeworld

EW FEATURE 56 Controversies in ophthalmology • June 2016 AT A GLANCE • LRIs are generally used for correcting 1.5 D or less of astigmatism. • Toric IOLs work best for perfectly symmetric astigmatism; for asymmetric corrections, use an LRI if the cornea is otherwise stable. • LRI nomograms must be age- and pachymetry-adjusted. by Lauren Lipuma EyeWorld Contributing Writer Surgeons discuss the pros and cons of each treatment O phthalmologists have 2 options for correcting astigmatism at the time of cataract surgery: limbal relaxing incisions (LRIs) and toric IOLs. Most surgeons agree that LRIs are best for small amounts of astigmatism and toric IOLs for larger amounts, but where exactly the line is drawn between them is still a matter of debate. Each method has advantages and disadvantages, and there are various factors to take into account when deciding which technique to use. Here, experienced refractive cat- aract surgeons Uday Devgan, MD, clinical professor of ophthalmolo- gy, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, chief of ophthalmology, Olive View Limbal relaxing incisions versus toric IOLs for astigmatism correction Monthly Pulse Controversies in ophthalmology EyeWorld Monthly Pulse EyeWorld Monthly Pulse is a reader survey on trends and patterns for the practicing ophthalmologist. Each month we send an online survey covering different topics so our readers can see how they compare to our survey. If you would like to join the hundreds of physicians who take a minute a month to share their views, please send us an email and we will add your name. Email carly@eyeworld.org and put EW Pulse in the subject line. A toric IOL on postop day 1 Source: Uday Devgan, MD UCLA Medical Center, and in private practice, Devgan Eye Surgery, Los Angeles; D. Rex Hamilton, MD, clinical professor of ophthalmology and director, UCLA Laser Refractive Center, Los Angeles; and Jeffrey Whitman, MD, Key-Whitman Eye Center, Dallas, Texas, discuss the pros and cons of each method and the factors that play into their deci- sions when choosing which option to use.

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