Treat ocular surface, undercorrect when biometry data vary before astigmatism correction
Click Here to Manage Email Alerts
NEW YORK — When a patient presents with varying preoperative biometry data for the astigmatism axis, surgeons should examine the ocular surface and go into the procedure with adequate expectations, according to one speaker here.
According to Uday Devgan, MD, there are several things a surgeon can do when different machines are showing different biometry data for the astigmatism axis.
First, look at the ocular surface and treat any ocular surface disease until it is under control.
“That is such a key point,” Devgan said. “It really does make sense — delay the surgery. I tell the patient, ‘You’re going to be looking through this surgery every day for the rest of your life. Just give me a month.’”
It is not possible to correct the cornea in every instance, Devgan said. Surgeons should lower expectations for situations in which not much can be done.
Physicians should be aware of contact lens use. When patients are regular contact lens users, surgery should be delayed for about a month with regular use of artificial tears and no contact lens wear for a more accurate biometer analysis, Devgan said.
Patients with higher degrees of astigmatism are easier to measure, with lower astigmatism more likely to vary on preoperative biometry readings, Devgan said.
“It is much easier with higher degrees of astigmatism, and that’s something to keep in mind,” he said.
Finally, Devgan said that in cases in which he has some doubt about the biometry data, he will undercorrect the astigmatism.
“When in doubt, undercorrect,” he said. “You can always do an LRI postop or LASIK or PRK in the postop period if you need to, and there are even some small LRI blades that kind of sit behind the slit lamp, so you can do it right at the clinic at the slit lamp.”
Collapse
Devgan U. What to do when the astigmatic axis varies with different pre-op biometers. Presented at: OSN New York and OSN New York Retina; Oct. 15-17, 2021; New York.
Read more about
Click Here to Manage Email Alerts