1564: on-axis incisions for toric IOLs

In most cases, I like to make the phaco incision on the steep meridian of corneal astigmatism. If the patient has a mild degree of astigmatism, the incision coupled with a limbal relaxing incision can address the corneal astigmatism completely. If the patient has 1 diopter or more of pre-existing corneal astigmatism, then the phaco incision coupled with a toric IOL can be used to address the astigmatism. But why do I like to make the phaco incision on-axis when we can simply calculate its effect and use the toric IOL to address the net resultant astigmatism? And what does vector math have to do with this? Well, let me tell you about airplanes and headwinds, tailwinds, and crosswinds…

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  1. could you explain how you use your tomography topography and the biometry information to make your decision for what IOL to implant in torics. Do you consider the posterior corneal astigmatism? what do you look out for from all the data you have infront of you? i would like to understand your thought process

    and which data do you base your decision on if they are not 100% matching?


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