Laboratory Studies

For any patient undergoing surgical correction of astigmatism, the patient’s general health is important. No routine laboratory workup is typically done, but the status of any concurrent systemic disease should be known.

Diabetes mellitus, in particular, is an example of one systemic disorder that can cause wide fluctuations in the refractive status of the eye. Prior to surgical treatment, diabetes should be well controlled, and relatively stable refractions should be performed over several visits.

Imaging Studies

The most important imaging studies for astigmatism correction are corneal topography and tomography.^{[39, 40, 31, 41]}These imaging studies are essential in understanding the shape and curvatures of the cornea, and they can be of tremendous help in establishing a diagnosis and in deciding management.

Corneal thickness using ultrasonic pachymetry may also be useful.

In patients who have had prior surgery, such as cataract surgery, phakic intraocular lens implantation, or keratoplasty, the corneal endothelium can be monitored using specular microscopy.

Treatment & Management

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Media Gallery

Typical astigmatic keratectomy incisions.
Wedge resection.
Corneal marker indicating optical zone diameter and degrees of arc.
LASIK for myopic with-the-rule astigmatism.
LASIK for myopic against-the-rule astigmatism.
LASIK for hyperopic with-the-rule astigmatism.
LASIK for hyperopic against-the-rule astigmatism.
Corneal topography of a central island.
Corneal topographies of decentered myopic ablations.
A properly aligned reticle. Note the position over the center of the pupil.
Infectious keratitis following LASIK. Note hyperemia, which typically does not occur in cases of diffuse lamellar keratitis.
Epithelial ingrowth following LASIK surgery.
Diffuse lamellar keratitis - Stage 1.
Diffuse lamellar keratitis - Stage 2.
Diffuse lamellar keratitis - Stage 3. Note central clumping of interface cells.
Diffuse lamellar keratitis - Stage 4. Note "cracked" appearance in central cornea following stromal melt.

of 16

Author

David R Hardten, MD Ophthalmologist, Phillips Eye Institute; Adjunct Clinical Associate Professor, Director of Refractive Surgery at Minnesota Eye Consultants, Pennsylvania College of Optometry; Clinical Associate Professor, Department of Ophthalmology, University of Minnesota Medical School, Minnesota Veterans Affairs Medical Center

David R Hardten, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Dompe, Glaukos, Johnson & Johnson<br/>Have a 5% or greater equity interest in: ESI, OSD<br/>Received consulting fee from OSD, Sightpath, for consulting; Received grant/research funds from Humanoptics; Received honoraria from Johnson & Johnson for speaking and teaching.

Coauthor(s)

Kate Montealegre, OD Staff Optometrist, Minnesota Eye Consultants, PA; Adjunct Faculty Clinical Instructor of Optometry, Illinois College of Optometry

Kate Montealegre, OD is a member of the following medical societies: American Academy of Optometry, American Optometric Association

Disclosure: Nothing to disclose.

Ahmad M Fahmy, OD Staff Optometrist, Minnesota Eye Consultants, PA; Adjunct Faculty Assistant Professor of Optometry, Illinois College of Optometry; Adjunct Faculty Assistant Professor of Optometry, Southern California College of Optometry

Ahmad M Fahmy, OD is a member of the following medical societies: American Academy of Optometry, American Optometric Association

Disclosure: Nothing to disclose.

Scott G Hauswirth, OD Consulting Staff, Department of Optometry, Minnesota Eye Consultants

Scott G Hauswirth, OD is a member of the following medical societies: International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Louis E Probst, MD, MD Medical Director, TLC Laser Eye Centers

Louis E Probst, MD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Chief Editor

Michael Taravella, MD Director of Cornea and Refractive Surgery, Rocky Mountain Lions Eye Institute; Professor, Department of Ophthalmology, University of Colorado School of Medicine

Michael Taravella, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Eye Bank Association of America

Disclosure: Received income in an amount equal to or greater than $250 from: J&J Vision (Consultant)/Proctor<br/> for: Coronet Surgical (Consultant), no income received.

Additional Contributors

Daniel S Durrie, MD Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center

Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology

Disclosure: Received grant/research funds from Alcon Labs for independent contractor; Received grant/research funds from Abbott Medical Optics for independent contractor; Received ownership interest from Acufocus for consulting; Received ownership interest from WaveTec for consulting; Received grant/research funds from Topcon for independent contractor; Received grant/research funds from Avedro for independent contractor; Received grant/research funds from ReVitalVision for independent contractor.

Sections LASIK for Correction of Astigmatism
Overview
Workup
Treatment
Media Gallery
References

LASIK for Correction of Astigmatism Workup

Laboratory Studies

Imaging Studies

References

Tables

Contributor Information and Disclosures

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