Astigmatism and Cataracts – James S. Lewis, MD
Serving Philadelphia, Northeast Philadelphia, Phoenixville, Conshohocken, Ambler, Abington, Jenkintown
Almost half of the eyeglass and contact lens wearing patients have been told they have astigmatism. It is rarely explained well. Astigmatism is the lack of radial symmetry of the eye’s visual system. That means an optical solution (glasses, contacts, LASIK, cataract surgery) must bend light differently in each meridian to allow parallel light from a distant object to focus perfectly on the fovea, the visual acuity center of the retina. In other words, a perfectly “spherical” system only requires a simple, spherical pair of glasses, contact lenses, LASIK surgery or Cataract Implants. The “astigmats”, however, need a more sophisticated solution.
During cataract surgery the cloudy natural lens is removed and replaced by an implant. Most astigmatism is produced by asymmetric curvature of the cornea and the natural lens. Once the lens is removed only the corneal astigmatism remains. Special implants can be used to eliminate the residual corneal astigmatism. There are several astigmatism-correcting implants on the market; we prefer the Alcon TORIC because it has excellent rotational stability. The Light Adjustable Lens is a new option that effectively neutralizes astigmatism following cataract surgery taking into account an individual’s unique healing characteristics.
Sometimes all of a Philadelphia cataract patient’s astigmatism is generated by the natural lens. In these cases cataract removal eliminates all astigmatism and a TORIC implant is not required. Sometimes a patient with no pre-operative astigmatism will manifest substantial post-operative astigmatism. Those patients have latent astigmatism and should be counseled about this pre–operatively. The Light Adjustable Lens can reliably and precisely eliminate residual astigmatism following surgery in all cases.
We will analyze and discuss your astigmatism prognosis before surgery and present your options.
Irregular astigmatism, an asymmetric form of astigmatism often associated with corneal disease, trauma, previous surgery, or hard/RGP lens wear is not always amenable to standard TORIC implants or excimer laser corneal sculpting. These patients are best served by the unique capabilities of the Light Adjustable Lens.
Astigmatism correction with cataract surgery, either by a TORIC implant, the Light Adjustable Implant, or topo-guided LASIK or PRK is an important advance in eye surgery. As a practice subspecializing in refractive cataract surgery, we pride ourselves on our success treating astigmatism.
Cartoon Cataract Surgery
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