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      Consensus on the management of astigmatism in cataract surgery

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          Abstract

          This project was aimed at achieving consensus on the management of astigmatism during cataract surgery by ophthalmologists from Latin America using modified Delphi technique. Relevant peer-reviewed literature was identified, and 21 clinical research questions associated with the definition, classification, measurement, and treatment of astigmatism during cataract surgery were formulated. Twenty participants were divided into seven groups, and each group was assigned three questions to which they had to respond in written form, after thoroughly reviewing the literature. The assigned questions with corresponding responses by each group were discussed with other participants in round 4 – presentation of findings. The consensus was achieved if approval was obtained from at least 80% of participants. The present paper provides several agreements and recommendations for management of astigmatism during cataract surgery, which could potentially minimize the variability in practice patterns and help ophthalmologists adopt optimal practices for cataract patients with astigmatism and improve patient satisfaction.

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          Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error.

          L N Thibos, W. Wheeler, D. Horner (1997)
          The description of sphero-cylinder lenses is approached from the viewpoint of Fourier analysis of the power profile. It is shown that the familiar sine-squared law leads naturally to a Fourier series representation with exactly three Fourier coefficients, representing the natural parameters of a thin lens. The constant term corresponds to the mean spherical equivalent (MSE) power, whereas the amplitude and phase of the harmonic correspond to the power and axis of a Jackson cross-cylinder (JCC) lens, respectively. Expressing the Fourier series in rectangular form leads to the representation of an arbitrary sphero-cylinder lens as the sum of a spherical lens and two cross-cylinders, one at axis 0 degree and the other at axis 45 degrees. The power of these three component lenses may be interpreted as (x,y,z) coordinates of a vector representation of the power profile. Advantages of this power vector representation of a sphero-cylinder lens for numerical and graphical analysis of optometric data are described for problems involving lens combinations, comparison of different lenses, and the statistical distribution of refractive errors.
          Article 0 comments Cited 245 times – based on 0 reviews     Review now
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            Contribution of posterior corneal astigmatism to total corneal astigmatism.

            Mitchell Weikert, Richard Jenkins, Li-Hsueh Wang … (2012)
            To determine the contribution of posterior corneal astigmatism to total corneal astigmatism and the error in estimating total corneal astigmatism from anterior corneal measurements only using a dual-Scheimpflug analyzer. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Case series. Total corneal astigmatism was calculated using ray tracing, corneal astigmatism from simulated keratometry, anterior corneal astigmatism, and posterior corneal astigmatism, and the changes with age were analyzed. Vector analysis was used to assess the error produced by estimating total corneal astigmatism from anterior corneal measurements only. The study analyzed 715 corneas of 435 consecutive patients. The mean magnitude of posterior corneal astigmatism was -0.30 diopter (D). The steep corneal meridian was aligned vertically (60 to 120 degrees) in 51.9% of eyes for the anterior surface and in 86.6% for the posterior surface. With increasing age, the steep anterior corneal meridian tended to change from vertical to horizontal, while the steep posterior corneal meridian did not change. The magnitudes of anterior and posterior corneal astigmatism were correlated when the steeper anterior meridian was aligned vertically but not when it was aligned horizontally. Anterior corneal measurements underestimated total corneal astigmatism by 0.22 @ 180 and exceeded 0.50 D in 5% of eyes. Ignoring posterior corneal astigmatism may yield incorrect estimation of total corneal astigmatism. Selecting toric intraocular lenses based on anterior corneal measurements could lead to overcorrection in eyes that have with-the-rule astigmatism and undercorrection in eyes that have against-the-rule astigmatism. The authors received research support from Ziemer Group. In addition, Dr. Koch has a financial interest with Alcon Laboratories, Inc., Abbott Medical Optics, Inc., Calhoun Vision, Inc., NuLens, and Optimedica Corp. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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              Dissatisfaction after implantation of multifocal intraocular lenses.

              Niels de Vries, Carroll Webers, Wouter Touwslager … (2011)
              To analyze the symptoms, etiology, and treatment of patient dissatisfaction after multifocal intraocular lens (IOL) implantation. Department of Ophthalmology, Maastricht University Medical Center, The Netherlands. Case series. In this retrospective chart review, the main outcome measures were type of complaints, uncorrected and corrected distance visual acuities, uncorrected and distance-corrected near visual acuities, refractive state, pupil diameter and wavefront aberrometry measurements, and type of treatment. Seventy-six eyes of 49 patients were included. Blurred vision (with or without photic phenomenon) was reported in 72 eyes (94.7%) and photic phenomena (with or without blurred vision) in 29 eyes (38.2%). Both symptoms were present in 25 eyes (32.9%). Residual ametropia and astigmatism, posterior capsule opacification, and a large pupil were the 3 most significant etiologies. Sixty-four eyes (84.2%) were amenable to therapy, with refractive surgery, spectacles, and laser capsulotomy the most frequent treatment modalities. Intraocular lens exchange was performed in 3 cases (4.0%). The cause of dissatisfaction after implantation of a multifocal IOL can be identified and effective treatment measures taken in most cases. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): Clinical Ophthalmology
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove Medical Press
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date Collection: 2019
                Publication date (Electronic): 11 February 2019
                Volume: 13
                Pages: 311-324
                Affiliations
                [1 ]Unit of Cornea, Cataract and Refractive Surgery, Grupo de Investigacion Vision Sana, Clinica de Oftalmología de Cali, Universidad Javeriana, Cali, Colombia, ximena@ 123456visionsana.com
                [2 ]Department of Cataract, Department of Research, Oftalmosalud Instituto de Ojos, Lima, Peru
                [3 ]Clinica Oftalmologica del Caribe (Cofca), Universidad Javeriana, Barranquilla, Colombia
                [4 ]Department of Cataract, Altino Ventura Foundation, HOPE Eye Hospital, Recife, Brazil
                [5 ]Centro de la Visión, Filial Clínica Las Condes, Universidad de Los Andes, Santiago de Chile, Chile
                [6 ]Lynd Newball Clinic, San Andres Islas, Colombia
                [7 ]Cataract and refractive surgery service, Espaillat Cabral Institute, Santo Domingo, Dominican Republic
                [8 ]Cataract service, IMO – Instituto de Moléstias Oculares, São Paulo, Brazil
                Author notes
                Correspondence: Maria X Núñez, Grupo de Investigacion Vision Sana, Clinica de Oftalmología de Cali, Universidad Javeriana, Cra 47 sur N 8c-94, Cali, Colombia, Email ximena@ 123456visionsana.com
                Article
                Publisher ID: opth-13-311
                DOI: 10.2147/OPTH.S178277
                PMC ID: 6376888
                PubMed ID: 30809088
                SO-VID: 14161559-e48f-4d10-84d7-c7a412cc9ef6
                Copyright © © 2019 Núñez et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Subject: Perspectives

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: management of astigmatism,astigmatism correction during cataract surgery,cataract patients with astigmatism,measurement and treatment of astigmatism,consensus on managing astigmatism
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: management of astigmatism, astigmatism correction during cataract surgery, cataract patients with astigmatism, measurement and treatment of astigmatism, consensus on managing astigmatism

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