New ways of measuring and treating irregular astigmatism

A symposium on Correction Of Irregular Astigmatism at the 16th ESCRS Congress highlighted the advances made over the past decade in the diagnosis and treatment of irregular astigmatism, the condition. Beatrice Cochener MD, France co-chaired the session with Pavel Stodulka MD, Czech Republic.


The session will commenced with a presentation by Thomas Kohnen MD, Germany, who provided his views on the definition of irregular astigmatism,. The first line of treatment for irregular astigmatism is the use of contact lenses, and Carina Koppen MD, Belgium provided a review on the refinements in contact lens material and design that have made them more amenable to the treatment of such eyes.

Prof Cochener noted that although contact lenses remain the best option whenever possible, keratoconus patients who have undergone keratoplasty due to contact lens intolerance will often find them unacceptable. The same is true of secondary ectasia patients who have undergone refractive surgery in the hopes of dispensing with glasses, she said.

The session continued with descriptions of the various surgical options available for patients in whom contact lenses are unsuitable, including a presentation by George Kymionis MD, Greece, on topography-guided ablation, and another by Dominique Pietrini MD, France, on intracorneal ring segments. In addition, Josep Guell MD, Spain, provided an update on lenticular approaches, while the final presentation, by Massimo Busin MD, examined the place of penetrating keratoplasty in the treatment of the condition.

Prof Cochener noted that the review of treatment options is timely given that many new possibilities have emerged over the past decade. In particular, collagen cross-linking has transformed the photoablative approach to such cases from an almost unthinkable option into a widely accepted technique.

'Two years ago all of these corneas would be regarded as contraindications to photo ablation for bio mechanical reasons. But the ability to link the ablation to a guided topography system and to reinforce the stability of the cornea with cross-linking has made this option a very promising way to deal with these irregularities although it is not applicable to all corneas,' she added.



Main Symposium
Correction of irregular astigmatism
Grand Ballroom
Saturday 4 February
17.00-18.30