For a Dense Cataract should we fix the astigmatism?

This patient has a dense, white cataract with a pre-op vision of just Counting Fingers at 1 meter (CF at 3 feet). She also has 2.5 diopters of corneal astigmatism. We were able to get reliable pre-operative biometry with a good topography and an accurate axial length via A-scan ultrasound. The question is do we fix her astigmatism at the same time as the cataract surgery?

The patient’s happiness with the surgery is the difference between her expectations and the results. We know that just by removing this very opaque cataract and implanting an IOL, she will be very happy, even if there is a significant residual post-op refraction.

We can do even better by maximizing her visual improvement by addressing the refractive error at the same time as the cataract. If we can take her from CF vision to 20/20 vision with a brief and easy cataract surgery, she will be absolutely amazed. This is one of the true miracles of modern medicine. Making a blind person see again, and specifically going from blind to 20/20, is a miracle.

Click below to learn from this surgery and the philosophy of maximizing the outcomes:

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