Surgeons describe their approaches with the four platforms available in the United States.
BY ERIC D. DONNENFELD, MD
Astigmatic management is the step that most often keeps patients from achieving optimal visual quality after refractive cataract surgery. Residual astigmatism of 0.50 D and sometimes less may result in glare, symptomatic blur, ghosting, and halos. A recent study of 4,540 eyes of 2,415 patients showed that corneal astigmatism was present in the majority of patients undergoing cataract surgery, with at least 1.50 D measured in 22.2% of study eyes.1 Approximately 38% of eyes undergoing cataract surgery have at least 1.00 D of preexisting corneal astigmatism, and 72% of patients have 0.50 D or more.2 The use of manual limbal relaxing incisions (LRIs), although moderately effective, has been an art form with inherent variability in its predictability. LRIs require expertise and entail some risk, and they simply are not performed by the great majority of ophthalmic surgeons. For these reasons, the need for a technology that improves the safety and effectiveness of corneal relaxing incisions is great.
Femtosecond lasers increase precision by creating reproducible incisions at the desired optical zone, depth, and length, all of which should make incisional treatment more of a science and less of an art.3
In a study of initial results with the LenSx Laser (Alcon), 8-mm arcuate incisions reduced astigmatism by 70%.4
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Robert J. Weinstock, MD, can be reached at Eye Institute of West Florida, 148 13th St. NW, Largo, FL 33770; 727-478-1299; or at http://cataractsurgeons.com for a consultation. email: email@example.com.
Robert J. Weinstock, M.D. is a board-certified ophthalmologist and is fellowship-trained in cataract and refractive surgery. He became interested in ophthalmology at an early age – as he watched and assisted his father. Dr. Weinstock has joined the practice in 2001 after completing his residency at the St. Louis University School of Medicine. He is the Director of Cataract and Refractive Services at the Eye Institute of West Florida and The Weinstock Laser Eye Center. #eyeinstituteofwestflorida #eyeinstituteofwestflorida He also is an associate clinical professor of ophthalmology at the University of South Florida, and serves as the Surgical Director of the Largo Ambulatory Surgery Center. He was named one of 250 in Premier Surgeon’s List of Leading Innovators of 2010 for his contributions to cataract surgery and premium IOLs. In addition to performing thousands of vision correcting cataract and LASIK #cataractsurgery procedures each year, Dr. Weinstock speaks and teaches nationally and internationally on customized cataract surgery and surgical innovations. He is continuously engaged in clinical research and studies to evaluate new technology, many of which are sanctioned by the FDA. He #drrobertweinstock is recognized internationally as an expert on new implant technology and microincisional surgical techniques. He has authored many book chapters on cataract surgery and continues to write journal articles on cataract and refractive surgery.
Undergraduate: Brandeis University, Waltham, MA
Medical School: The Chicago Medical School, IL
Internship: St. John’s Mercy Medical Center, St. Louis, MO
Residence: St. Louis University School of Medicine, MO
Fellowship: The Eye Institute of West Florida
Board Certifications: American Board of Ophthalmology, Cataract Certification (Sub-Specialty) Cataract/Implant Surgery, American Board of Eye Surgery, LASIK Certification (Sub-Specialty) Refractive Surgery
Academic Appointment: Assistant Clinical Professor, Department of Ophthalmology, University of South Florida, Tampa
Specialty: Refractive Cataract & LASIK Surgery