LASIK most effective in correcting astigmatism at corneal plane

LASIK proved markedly more effective in treating corneal astigmatism than treating noncorneal ocular residual astigmatism, or ORA, a study found.

"If it is less efficacious to treat astigmatism with an anterior corneal-confined procedure, such as LASIK, in eyes with significant ORA, it may be important to identify such cases preoperatively," the study authors said. "The results suggest that treating astigmatism with LASIK based on manifest refraction results in a successful outcome only if the preoperative refractive astigmatism arises primarily from the anterior corneal surface."

The retrospective study included 61 eyes of 61 patients; 30 patients had low ORA and 31 patients had high ORA.
 
Results showed that 75% of preoperative refractive astigmatism was successfully treated in the low-ORA group and 50% of refractive astigmatism was treated in the high-ORA group. The difference was statistically significant (P = .036).

Correction of noncorneal astigmatism can also be problematic for cataract patients, the authors said.
"Perhaps the best approach to the management of astigmatism in a cataract surgery patient is to balance the treatment based on the cornea and the ORA. Further work in this area is needed," they said.

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