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Residual corneal astigmatism after cataract surgery can reduce uncorrected visual acuity and patient satisfaction. This randomized clinical trial compared femtosecond laser arcuate keratotomy with toric intraocular lens implantation in patients with mild-to-moderate regular astigmatism undergoing femtosecond laser-assisted cataract surgery. The study found differences in postoperative refractive outcomes, supporting both strategies as clinically useful ways to address astigmatism. The value of a toric IOL is that cylindrical correction is incorporated into the implant itself, while arcuate keratotomy modifies the cornea. For HCPs, the choice should be driven by the magnitude and regularity of astigmatism, corneal topography, ocular surface status, surgically induced astigmatism and the surgeon's ability to control the arcuate incision parameters. The trial reinforces an important principle in refractive cataract practice: preoperative measurements and accurate axis management are as important as the choice of technology. Patients should also understand that the goal is to minimise residual astigmatism rather than guarantee spectacle independence. The study fits AIOC's focus on premium IOLs, FLACS and refractive optimisation.
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Residual corneal astigmatism after cataract surgery can reduce uncorrected visual acuity and patient satisfaction. This randomized clinical trial compared femtosecond laser arcuate keratotomy with toric intraocular lens implantation in patients with mild-to-moderate regular astigmatism undergoing femtosecond laser-assisted cataract surgery. The study found differences in postoperative refractive outcomes, supporting both strategies as clinically useful ways to address astigmatism. The value of a toric IOL is that cylindrical correction is incorporated into the implant itself, while arcuate keratotomy modifies the cornea. For HCPs, the choice should be driven by the magnitude and regularity of astigmatism, corneal topography, ocular surface status, surgically induced astigmatism and the surgeon's ability to control the arcuate incision parameters. The trial reinforces an important principle in refractive cataract practice: preoperative measurements and accurate axis management are as important as the choice of technology. Patients should also understand that the goal is to minimise residual astigmatism rather than guarantee spectacle independence. The study fits AIOC's focus on premium IOLs, FLACS and refractive optimisation.
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