The femtosecond laser used for bladeless cataract surgery can create incisions in the cornea to lower astigmatism at the time of the cataract procedure. Watch this episode of A State of Sight with Isaac Porter, MD to learn how astigmatic keratotomy can reduce astigmatism.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care. Today, I would like to explain the correction of astigmatism using bladeless cataract surgery.

This has recently become widely available. Two of the primary main laser systems are Alcon’s LenSx laser and AMO’s Catalys laser. These are an adaptation of the femtosecond technology that we have been using for LASIK to create a flap in the cornea.

By adapting this laser and using similar technology, we can now use the technology for several steps of the cataract procedure. This includes opening the lens, softening the lens, creating corneal incisions, and creating astigmatic keratotomy incisions to reduce astigmatism.

To create incisions, the laser creates a series of pulses that create many bubbles in the cornea that has the effect of cutting the cornea.

In order to lower the astigmatism, these cuts or incisions are placed in the cornea in the steep area. Where the cornea is too steep, this incision goes through most of the depth of the cornea and it allows it to open some and relax so that curvature isn’t as steep.

The length of the incision is related to the effect that we get and amount of astigmatism that we want to treat.

It is not as accurate as placing a toric lens implant or using LASIK to treat astigmatism. However, the main goal with astigmatic keratotomy is to reduce the astigmatism and bring it to a lower level.

Many people have astigmatism, I have a little bit myself, but since it is a small amount I don’t need to use any correction for it. Fortunately, I don’t have any nearsightedness or farsightedness so I can see very well without glasses.

With this laser surgery, if astigmatism is reduced to a low level, it doesn’t affect vision very much.

Let me know if you have any questions about this procedure, we will be happy to answer them. We hope to see you again soon, next time on A State of Sight.