Scientific Online Resource System

Bulgarian Review of Ophthalmology

Astigmatism management during cataract surgery

I. Kuneva, V. Daskalov, D. Dimitrov, R. Trajkovski, M. Memish


Objective: To share our experience in correcting corneal astigmatism in patients undergoing cataract surgery.

Methods: Our study includes 48 eyes, 37 eyes with a corneal astigmatism of up to 2.50 dpt and 11 eyes with a higher (>2.50dpt) astigmatism. The first group was treated with arcuate keratotomies (AK) performed by B&L VICTUS Femtosecond Laser Platform. The AKs were placed on the steepest corneal meridian in a resulting depth of 85% based on the real-time OCT pachymetry. Patients from group 2 were treated with intraocular toric IOLs.
Postsurgical follow-up period was 18 months and includes uncorrected visual acuity, manifest refraction, count and density of endothelial corneal cells prior to and after surgery, pachymetry, corneal topography (Placidobased and Scheimpflug image -derived topography).

- The mean astigmatismus reduction in the first group was from 1.71 D ± 0.63 (SD) to 0.28 ± 0.39 D (P<.001)
- The mean astigmatismus reduction in the second group was from -3.75 D ± 1.10 (SD) to -0.38 ± 0.51 D (P<.001)

Conclusion: Contemporary methods for correction of corneal astigmatism allows high uncorrected visual acuity in patients undergoing cataract surgery.


astigmatis; toric IOLs; arcuate keratotomies

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About The Authors

I. Kuneva
Pentagram Eye Hospital, Sofia, Bulgaria

V. Daskalov
Pentagram Eye Hospital, Sofia, Bulgaria

D. Dimitrov
Pentagram Eye Hospital, Sofia, Bulgaria

R. Trajkovski
Pentagram Eye Hospital, Sofia, Bulgaria

M. Memish
Pentagram Eye Hospital, Sofia, Bulgaria