Observation Of The Surgical Outcome Of Irregular Astigmatism Combined With Cataract Surgery (Including Surgical Video)

 Observation of the cataract surgery outcomes in patients with irregular corneal astigmatism

Lixiang Eye Hospital of Soochow University

76-year-old retired female healthcare worker presented on 12 June 2019 with two years of blurred vision in right eye and poor left eye vision since childhood. Examination showed uncorrected visual acuity of 0.3 OD and 0.1 OS, with irregular astigmatism >1.5D bilaterally. Slit-lamp examination revealed corneal epithelial punctate staining and lens opacity (N3P1) bilaterally, with an intraocular lens power of 14D and 45° exotropia in the left eye. Following treatment for grade 2 dry eye, corneal astigmatism reduced to within 1D. The left eye subsequently underwent femtosecond laser-assisted capsulorhexis and nuclear splitting, followed by phacoemulsification and implantation of a one-piece flat plate loop regional refractive intraocular lens.

On the first day post-surgery, the left eye's distance vision was 0.8, intermediate vision was 0.8, and near vision was 0.8. On the first postoperative day, the right eye's distance vision was 1.0, intermediate vision was 1.0, and near vision was 1.0. The patient was satisfied. During the follow-up 2 years post-surgery, the diagnosis was dry eye syndrome.

Irregular corneal astigmatism before cataract surgery can be caused by dry eye, and some patients may even have systemic diseases. Ocular surface treatment can improve corneal astigmatism, so that functional intraocular lens implantation can be planned to improve the distance, intermediate and near vision of patients.