EW CATARACT
33
May 2017
tismfix.com and the toric calculator
developed by John Berdahl, MD,
Sioux Falls, South Dakota, and
David Hardten, MD, Minneapolis.
"That will tell me if rotating the
toric IOL will get me the result that I
need," he said. "If it does, I do that.
If it doesn't, I either do IOL ex-
change or I can do an excimer laser
with LASIK or PRK to get rid of the
residual refractive error."
Addressing the different compo-
nents of astigmatism management
gives patients better outcomes,
but at the end of the day, there are
always going to be some surprises,
Dr. Yeu said.
"I think it's important that we
be kind to ourselves and understand
that the occasional refractive sur-
prise outcome is inevitable, no mat-
ter how accurate our measurements
are and how pristinely our surgeries
are performed. We do need to have
ways that we can fix our surprises,"
she said. She recommends being
mindful of potential surprises and
aware of the techniques surgeons
can use to mitigate them, whether
they be realignment of the lens, lens
exchange, excimer laser ablation, or
relaxing incisions.
"Fortunately, [having] resources
that are of very low cost to us, such
as advanced online calculators at our
fingertips that account for effective
lens position and posterior corneal
astigmatism, in combination with
good topography and good biome-
try, will yield us very happy patients
overall," she said. EW
References
1. Koch DD, et al. Correcting astigmatism with
toric intraocular lenses: effect of posterior
corneal astigmatism. J Cataract Refract Surg.
2013 Dec;39(12):1803–9.
2. Koch DD, et al. Contribution of posterior cor-
neal astigmatism to total corneal astigmatism.
J Cataract Refract Surg 2012;38:2080–7.
Editors' note: Dr. Abulafia has finan-
cial interests with Haag-Streit, HOYA
(Singapore), and PhysIOL (Liège,
Belgium). Dr. Greenwood has financial
interests with Alcon (Fort Worth, Tex-
as). Dr. Yeu has financial interests with
Alcon, Abbott Medical Optics (now
Johnson & Johnson Vision, Santa Ana,
California), and i-Optics.
Contact information
Abulafia: adi.abulafia@gmail.com
Greenwood: michael.greenwood@van-
cethompsonvision.com
Yeu: eyeulin@gmail.com
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