(EMAILWIRE.COM, June 17, 2009 ) Dr. John Suson, of Suson Eye Specialists in Wauwatosa, WI, recently explained how he treats astigmatism in cataract and refractive surgery at his Wisconsin clinic.

"Astigmatism is a much misunderstood concept among the general public in my experience. It’s a word that many people have heard but have only a vague, if any, understanding of its meaning. Most people have a general understanding of nearsightedness (myopia) and farsightedness (hyperopia), although sometimes they get the two confused. Because of the focal power of their eyes, nearsighted people see much better up close but not very well far away. On the other hand, farsighted people see better far away than up close. If you are severely farsighted, even relatively far objects may be too close to bring into focus," Suson explained.

But astigmatism doesn’t really fit into either of these neat categories. It is also related to the shape of the eye, but it has to do with the irregular or uneven curvature on the front of the eye or cornea. A perfect eye would be completely round or spherical, like a basketball. If you take that ball and squeeze it so that it becomes more oval like a football, then that creates the shape that leads to astigmatism. Since the astigmatic eye does not have an even curvature on its front corneal surface, light is focused differently in different directions. The effect is to create blur, ghost images, and shadowing of objects.

Many people are still under the mistaken belief that if you have astigmatism that nothing can be done for you. That is not true. In the early days of the refractive lasers, PRK and Lasik did not have the ability to correct for astigmatism. Some of the older, outdated lasers may still not have the ability to do so, but modern updated lasers are definitely able to correct for a fairly significant amount of astigmatism. Other options for astigmatism correction also exist.

Correcting astigmatism has become a major part of both cataract and refractive surgery (e.g. Lasik) for many years. Astigmatism correction was actually perfroemd prior to the development of laser refractive surgery. During the Radial Keratotomy (RK) days, diamond blades were used to incise the cornea which would induce healing and flattening of the cornea in relatively predictable ways. RK could be performed to reduce nearsightedness and a closely related cousin, Astigmatic Keratotomy (AK), was performed to reduce astigmatism.

AK uses arcuate incision placed peripherally in a tangential manner in the cornea. These AK incisions were placed in the axis of the steepest curvature of the cornea in order to flatten it along that meridian and cause the cornea to become more uniformly rounded. Based on a series of factors including degree of astigmatism, location, and patient age, the length and depth of the incisions were determined in a relatively predictable way to correct a given amount of astigmatism.

Today, this procedure has become relatively common to reduce corneal astigmatism for patients that are already undergoing cataract surgery with lens implants. A slightly modified version called Limbal Relaxing Incisions (LRIs) is the most common method. LRIs are AK incisions that are placed as far out in the peripheral cornea as possible. It is a quick and inexpensive method to reduce astigmatism which does not require any additional laser equipment.

"LRIs are also sometimes used in cases where there is a modest amount of corneal astigmatism after Lasik surgery. The advantage of doing LRIs in this case is that it is very fast healing and there is no need to relift the flap or disrupt the corneal epithelium. If there is any residual nearsightedness or farsightedness, it may be a better alternative to treat the astigmatism with a laser," Dr. Suson explained.

A somewhat newer alternative to treating astigmatism has come in the form of Toric IOLs (intraocular lens implants). These are lens implants that have a Toric (oval/cylindrical) lens shape and can be place into the eye after cataract surgery to reduce the astigmatism. These IOLs can work very well although positioning is quite important. If they shift position significantly, they may not adequately reduce the patient’s astigmatism. Any additional residual astigmatism after Toric IOL implant could be addressed either by laser refractive surgery or by incisional LRIs.

So for those who thought there was no treatment for astigmatism, that is definitely not true. Depending on your situation, your astigmatism may be treatable by simple incisional corneal surgery (LRI), by laser refractive surgery (Lasik or PRK), or by intraocular lens implants (Toric IOLs). "If you were seeking treatment for astigmatism but were told in the past that nothing could be done, you should definitely contact us to find out your options," Dr. Suson suggested, on behalf of Suson Eye Specialists.





For more information about lasik eye surgery - in addition to scores of other eye-related procedures, such as cataract surgery - visit Dr. John Suson's blog, at http://www.supereyes.com/blog/

To book a consultation with Dr. Suson, or to learn more about Suson Eye Specialists, visit http://www.supereyes.com/

Contact Information:
Suson Eye Specialists
Dr. John Suson
Tel: 414-778-2020
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