Irregular Astigmatism Management

The term irregular astigmatism is often applied to a distorted corneal topography, whereby two major meridians may not even be easily identified; in simple terms, it can be defined as an “unrefractable” eye. As a consequence, visual function can be severely affected. Conventional treatments are often insufficient and/or unsatisfactory. Spectacles may lead to intolerable aniseikonia, and contact lens fitting is usually challenging. Conservative approaches do not always yield maximal visual results leaving the patient unsatisfied. Numerous surgical procedures have been developed trying to improve astigmatism, including relaxing incisions, thermal and conductive keratoplasty, wedge  E-mail: [email protected]. No part of this digital document may be reproduced, stored in a retrieval system or transmitted commercially in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services. L. Pedro-Aguilar, A. Navas, and E. Graue-Hernandez 116 resections, photorefractive procedures, phakic and intraocular lens implantation, among others. Each procedure needs to be evaluated within the patient’s context and chosen accordingly. The purpose of this chapter is to review the most commonly used techniques for the correction of irregular astigmatism.