Everything concerning the management of the post-operative step is of the utmost importance for the successful outcome of cataract surgery with toric IOLs. So we think that Professor Gerd U. Auffarth is the ideal guest of this international panel for his huge clinical records and his important clinical and surgical studies in order to provide us with practical advice both concerning the final choices, immediately close to the surgical operation, and the solution of the small problems which can occur in the immediate postoperative phase
What are the advantages of cataract toric surgery vs AK (Astigmatic Keratotomy) procedures, also femtolaser ones?
Toric intraocular lenses have become a standard in cataract and refractive surgery. It has been shown, that they can effectively compensate corneal astigmatism with very high precision. Special surgical guidance systems, instruments for axis marking, have evolved extremely in the last years. A big advantage of toric IOL implantation is the effect, that you can more less correct any kind of astigmatism, even very high astigmatic correction for example after PKP (Fig. 1).
Especially in Europe a lot of companies offer individualized toric IOLs. Toric IOLs make sense from 1.0 to 1.5 diopters astigmatism upwards. Below that value there is still a place for astigmatic keratotomy manually or by femtolaser. The disadvantages of the AK are the limited range of corrections and the longterm stability. However especially below 1.0 diopter incisional technics and AK are good alternatives (Fig. 2).
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