surgical intraoperative management of astigmatism

- Dra. Alba Coronado

- Dra. Beatriz Puerto

- Dr. Jorge García

- Dra. MªJose Merino

- Dr. Carlos Veiga

- Dra. Fé Moreno

- Dra. Andrea Sanz

- Dr. Fco.Javier Hurtado

Dr. Laureano A-Rementería

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MAIN INCISION

GETTING SMALLER

LESS INDUCED ASTIGMATISM

NO SENSE TO MARK STEEPEST AXIS

MAIN INCISION AT MOST CONFORTABLE AXIS

SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISMOPPOSITE CLEAR CORNEAL INCISIONS

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OPPOSITE CLEAR CORNEAL INCISIONS

EASY

NO EXPENSIVE MATERIAL

PREDICTABLE IN LOW ASTIGMATISM


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WE TRY TO REDUCE THE PREVIOUS ASTIGMATISM TROUGH CLEAR

CORNEAL INCISIONS AT THE STEEPEST AXIS


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WE MARK WITH YAG LASER AT THE SLIT LAMP

IT CAN BE DONE THE DAY BEFORE


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WITH THE RULE

1-2 D 2 INCISIONS at 9mm


+ 3 D NOT INDICATED

2.5mm diamond blade


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AGAINST THE RULE



+ 3 D NOT INDICATED

2.5mm diamond blade


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0

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1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95 97

PREOP CORNEAL ASTIGMATISM


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POSTOP CORNEAL ASTIGMATISM

0

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1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95 97


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AVERAGE

1,58

0,91

0,63

0,00

0,20

0,40

0,60

0,80

1,00

1,20

1,40

1,60

1,80

PREOP POSTOP TEORICO POST


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% PATIENTS BELOW 1 Dp.

18

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DIFFERENCES ACCORDING TO THEORIENTATION OF CORNEAL ASTIGMATISM

2,02

1,11

0,91

1,48

0,84

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0,59

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PREOP POST TEORICO POST

DIRECTO

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OBLICUO


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COMPARISON BETWEEN SUBJECTIVE PREOPERATIVE ASTIGMATISM AND

CORNEAL PREOPERATIVE ASTIGMATISM ACCORDING TO THEIR PREOPERATIVE ORIENTATION

1,11

0,84 0,82

0,45

0,870,82

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1,20

DIRECTO INVERSO OBLICUO

CORNEAL

SUBJETIVO


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CONCLUSSIONS

• OPPOSITE CLEAR CORNEAL INCISIONS ARE VERY PREDICTABLE IN CORNEAL ASTIGMATISM UP TO 2 DIOPTERS.

• PATIENTS TOLERATE BETTER THE RESIDUAL ASTIGMATISM BETTER WITH OF THE RULE.

• THE PRECISION IN THE AXIS OF THE INCISION IS IMPORTANT.

• WE CAN HAVE MORE MULTIFOCAL PATIENTS.

• OUR PERCENTAGE OF TOUCH UP WITH LASER DECREASES.

c\ Almagro 36,entreplanta derecha28010 MADRID

Telf: 91 308 38 38

[email protected]

THANK YOUFOR YOUR ATTENTION

surgical intraoperative management of astigmatism

Health & Medicine