Title : Optimizing astigmatism management in refractive cataract surgery
Abstract:
Astigmatism management is one of the two main objectives of refractive cataract surgery, with toric intraocular lens (IOL) implants serving as the cornerstone intraoperative modality for effective correction. Successful outcomes depend on careful preoperative assessment and meticulous intraoperative planning. This presentation will examine the essential considerations for determining when a toric IOL is indicated, including evaluation of the magnitude and axis of astigmatism, the impact of surgically induced astigmatism, and the integration of posterior corneal astigmatism into the surgical plan.
The role of diagnostic technologies such as optical biometry, corneal topography, and intraoperative aberrometry will be reviewed, highlighting their complementary value in achieving consistent and reproducible outcomes. The benefits and limitations of direct posterior corneal astigmatism measurement will also be explored, alongside the contribution of femtosecond laser platforms in enhancing alignment precision. A key focus will be placed on toric IOL stability, addressing the mechanisms of postoperative rotation, strategies to minimize misalignment, and methods for effective management when rotation occurs.
Practical guidance will be provided for lens selection, intraoperative alignment, and postoperative follow-up, particularly with respect to capsular tension rings, reverse optic capture techniques, and other adjunctive measures to improve long-term stability. The presentation will also offer practical selection criteria to support surgeons who are new to toric IOL implantation, ensuring that accurate correction of corneal astigmatism can be consistently achieved. By synthesizing current evidence and surgical experience, this session aims to provide a comprehensive framework for optimizing accuracy, safety, and visual outcomes in refractive cataract surgery with toric IOLs.
Keywords: toric IOL, astigmatism correction, refractive cataract surgery, toric IOL rotation, capsular tension ring, reverse optic capture, posterior corneal astigmatism.
