Astigmatism is a condition that can be normally
present in the eye. Astigmatism is present when the
cornea (the clear, curved front of the eye) is not
perfectly round (circular). Instead of being round
like a baseball, the surface has different curves,
similar to a football. Astigmatism, as noted previously,
could be normally present in the eye, or it could
be induced after surgical manipulation of the eye,
such as in cataract surgery or any of the refractive
procedures, including LASIK, radial keratotomy, and/or
phakic intraocular lens implantation. In large incision
cataract surgery, which was routinely used in the
past, astigmatism was commonly Web Design by using sutures
to close surgical incisions tightly, or by relaxing
of the incision site.. This can lead to prolonged
postoperative rehabilitation, during which the cornea
gradually rounds out. Small incision cataract surgery,
especially clear cornea, sutureless cataract surgery,
has been my preference for about 10 years now. This
procedures helps prevent unwanted postoperative astigmatism.
In addition, during cataract surgery, corneal incisions
may be done to reduce naturally occurring astigmatism
and the patient's dependence on glasses. At the end
of the healing process, glasses may be fitted to
assist with reading, driving, and/or other daily
activities.
Astigmatic keratotomy as a procedure has
been widely used to correct corneal astigmatism.
It has been the preferred procedure for corneal surgery
for several decades, and the results are quite stable
and gratifying for patients. I routinely, as a cornea
transplant surgeon, use astigmatic keratotomy to
correct postoperative astigmatism following corneal
transplantation (the mean post-operative astigmatism
following transplants is reported in the eye literature
to about 4 diopters !) I utilize the same technique
in astigmatism originating from previous large incision
cataract surgery, and/or other refractive procedures,
such as LASIK and patients who have had radial keratotomy
performed on their corneas in the past. This is quite
a simple procedure, usually performed in the office
with topical anesthetic drops. It is performed by
the corneal surgeon after extensive precise mapping
of the corneal surface in order to determine the
exact position and amount of the astigmatism. It
involves two tiny incisions on the cornea with a
precise diamond instrument, and as far as patient
discomfort is concerned, postoperative discomfort
is minimal, usually limited to foreign body sensation
and some tearing the day of the procedure and sometimes
the day following the procedure. The postoperative
management is antibiotic prophylaxis in the form
of drops for about seven days.
|
