Astigmatism management

Astigmatism management has evolved dramatically over the last 10 years. Whe reas astigmatic keratotomy (AK) has, until recently, been the primary modal ity in use, new developments such as excimer laser corneal ablation, modifi ed cataract incisions, and toric intraocular lenses (IOLs) have changed the refractive surgical landscape. Cataract surgery has become a true refracti ve surgical, procedure, and laser-assisted in situ keratomileusis (LASIK) h as vastly simplified the correction of astigmatism. Custom corneal ablation s and wave-front technology for irregular astigmatism and other optical abe rrations promise continued progress. The goal of astigmatism reduction and better uncorrected visual acuity for all is now dearly within our sights. In this chapter, we discuss the currently employed techniques for managing astigmatism, with a focus on the most recent developments. The present role of AK will be discussed. We will also review the management of astigmatism in the cataract patient. Finally, use of excimer laser corneal ablation fo r the treatment of astigmatism will be summarized.