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    Aspiring for zero tolerance of residual astigmatism

    Case examples highlight tools, techniques toward quest for excellent visual endpoint


    Figure 12 shows how the surgeon can use astigmatism to his or her advantage.

    In this case, I was able to align the resultant astigmatism to be in the axis of a corneal scar. Using the VISX laser in Corneoplastique mode can clear the corneal scar and correct the astigmatism to emmetropia. Flipping the axis using a toric IOL can be used to correct the cornea with the “inside-out” technique.

    The topographic results at the bottom of the slide show the results in patients who have had correction of a corneal scar and irregular astigmatism to a measurable, regular refractive astigmatism endpoint, which then was corrected during cataract surgery with implantation of a toric IOL to achieve emmetropia.

    Arun C. Gulani, MD
    Dr. Gulani is director of refractive surgery and chief, cornea & external disease, as well as assistant professor, department of ...

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