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A combination of procedures could be best option for some patients, claims Dr Volker Rasch.
Despite the availability of modern and technologically advanced diagnostic instruments, there is still a chance of missing targeted refraction. One reason for this is the variability of the anterior chamber during biometry; another is the difficulty the ophthalmologist can encounter with ultrasound biometry in patients with a more mature cataract. Furthermore, astigmatism can play a role in a less-than-perfect outcome. Although modern multifocal IOLs are able to match astigmatism of up to one diopter, higher astigmatism requires a toric IOL or additional correction, such as with laser refractive methods.
LASICAT can be performed in different ways. Creating the flap might be the first step, followed by cataract surgery within up to six weeks, renewed measurements and diagnosis two months postoperatively. The remaining refractive error, astigmatism and higher order aberrations might then be treated with a LASIK procedure. In cases of posterior capsule opacification (PCO), YAG capsulotomy may be carried out.
Here, I would like to report on five case studies that I have treated recently.
LASICAT is an up-to-date procedure that some cataract and refractive surgeons are offering to those patients who are expecting the best possible visual acuity after an eye procedure and who insist on almost complete independence from glasses. Long-term studies will evaluate the potential of this tool, which will surely develop with further innovations in both laser technology and IOL design.