Abstract
This chapter mainly deals with corneal astigmatism as a common type of astigmatism and postoperative visual acuity. Since moderate corneal astigmatism deteriorates retinal images, causing a decrease in visual performance and monocular diplopia, correction is important. The toric intraocular lens (IOL) is useful, and coping with axis shift is the key point. Since we encountered a patient with the long axial length and the with-the-rule astigmatism who showed a marked axis shift immediately after surgery, caution is necessary. Also, the toric phakic IOL and laser correction of astigmatism such as laser in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) are useful in non-cataractous eyes with adequate accommodative power. The limbal relaxing incisions (LRIs) are safe, inexpensive, and require no special equipment such as lasers, although the correction effects of LRIs are inadequate. At present, avoidance of oblique astigmatism and a reduction of ocular astigmatism to 1.0 diopter (D) or less are important. In the future, consideration should also be given to the pupil diameter, posterior corneal astigmatism, and influences on pseudo-accommodation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kronish JW, Forster RK. Control of corneal astigmatism following cataract extraction by selective suture cutting. Arch Ophthalmol. 1987;105:1650–5.
Lindstrom RL. The surgical correction of astigmatism: a clinician’s perspective. Refract Corneal Surg. 1990;6:441–54.
Gills JP, Gayton JL. Reducing pre-existing astigmatism. In: Gills JP, Fenzl R, Martin RG, editors. Cataract surgery: the state of the art. Thorofare: Slack; 1998. p. 53–66.
McDonnell PJ, Moreira H, Garbus J, Clapham TN, D’Arcy J, Munnerlyn CR. Photorefractive keratectomy to create toric ablations for correction of astigmatism. Arch Ophthalmol. 1991;109:710–3.
Ayala MJ, Perez-Santonja JJ, Artola A, Claramonte P, Alio JL. Laser in situ keratomileusis to correct residual myopia after cataract surgery. J Refract Surg. 2001;17:12–6.
Sekundo W, Kunert KS, Blum M. Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study. Br J Ophthalmol. 2011;95:335–9.
Misawa A, Shimizu K. Small-incision surgery and cylinder IOL. In: Abstracts of the 14th Japanese society of ophthalmic surgeons, Saitama, Japan, 25–27 January 1991.
Shimizu K. Effects of Toric IOL. In: Abstracts of the 2nd American-international congress on Cataract, IOL and refractive surgery and congress on ophthalmic practice management, San Diego, USA, 12–14 April 1992.
Shimizu K, Misawa A, Suzuki Y. Toric intraocular lenses: correcting astigmatism while controlling axis shift. J Cataract Refract Surg. 1994;20:523–6.
Miyake T, Kamiya K, Amano R, Shimizu K. Corneal astigmatism before cataract surgery. Nihon Ganka Gakkai Zasshi. 2011;115:447–53.
Kobashi H, Kamiya K, Shimizu K, Kawamorita T, Uozato H. Effect of axis orientation on visual performance in astigmatic eyes. J Cataract Refract Surg. 2012;38:1352–9.
Vass C, Menapace R, Schmetterer K, Findl O, Rainer G, Steineck I. Prediction of pseudophakic capsular bag diameter based on biometric variables. J Cataract Refract Surg. 1999;25:1376–81.
Kim H, Joo CK. Ocular cyclotorsion according to body position and flap creation before laser in situ keratomileusis. J Cataract Refract Surg. 2008;34:557–61.
Miyata K, Miyai T, Minami K, Bissen-Miyajima H, Maeda N, Amano S. Limbal relaxing incisions using a reference point and corneal topography for intraoperative identification of the steepest meridian. J Refract Surg. 2011;27:339–44.
Kamiya K, Shimizu K, Igarashi A, Komatsu M. Comparison of Collamer toric implantable [corrected] contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism. J Cataract Refract Surg. 2008;34:1687–93.
Kamiya K, Shimizu K, Kobashi H, Igarashi A, Komatsu M. Three-year follow-up of posterior chamber toric phakic intraocular lens implantation for moderate to high myopic astigmatism. PLoS One. 2013;8:e56453.
Kamiya K, Shimizu K, Ando W, Asato Y, Fujisawa T. Phakic toric implantable Collamer lens implantation for the correction of high myopic astigmatism in eyes with keratoconus. J Refract Surg. 2008;24:840–2.
Kamiya K, Shimizu K, Hikita F, Komatsu M. Posterior chamber toric phakic intraocular lens implantation for high myopic astigmatism in eyes with pellucid marginal degeneration. J Cataract Refract Surg. 2010;36:164–6.
Miyake T, Kamiya K, Amano R, Iida Y, Igarashi A, Ishii R, Shimizu K. Distribution and comparison of anterior, posterior and total corenal astigmatism. In: Abstracts of the 117th annual meeting of the Japanese ophthalmological society, Tokyo, Japan, 4–7 April 2013.
Miyake T, Kamiya K, Shimizu K. Evaluation of corneal astigmatism of the posterior surface in eyes with with-the-rule and against-the-rule astigmatism of the anterior surface. In: Abstracts of the 28th annual meeting of the Japanese society of cataract and refractive surgery, Chiba, Japan, 27–29 June 2013.
Koch DD, Shazia FA, Weikert MP, Shirayama M, Jenkins R, Wang L. Contribution of posterior corneal astigmatism to total corneal astigmatism. J Refract Surg. 2012;38:2080–7.
Sawusch MR, Guyton DL. Optimal astigmatism to enhance depth of focus after cataract surgery. Ophthalmology. 1991;98:1025–9.
Conflicts of Interest
The author declares no conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Japan
About this chapter
Cite this chapter
Shimizu, K. (2014). Corneal Astigmatisms and Postoperative Visual Acuity. In: Bissen-Miyajima, H., Koch, D., Weikert, M. (eds) Cataract Surgery: Maximizing Outcomes Through Research. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54538-5_6
Download citation
DOI: https://doi.org/10.1007/978-4-431-54538-5_6
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-54537-8
Online ISBN: 978-4-431-54538-5
eBook Packages: MedicineMedicine (R0)