Astigmatism treatment

International methods of diagnosis and treatment of astigmatism

Diagnostics includes an ophthalmologist performing eye tests and determining refraction (autokeratorefractometry). Further, doctors draw conclusions about the cause, type and complexity of astigmatism using the following methods:

• Corneal topography,
• Measurement of corneal thickness (pachymetry),
• Examination with a slit lamp,
• Scheimpflug camera,
• Placido’s disc,
• Confocal microscopy of the cornea,
• Screening Belin-Ambrosio,
• OCT of the anterior segment.

On the MedTour platform, you will find experienced doctors who have innovative diagnostic equipment and will deliver an accurate diagnosis.

Scheimpflug camera

The Scheimpflug camera forms an image in the section of the anterior segment of the eye in different planes. Based on this, a 3D model of the entire cornea can be calculated.

Keratotopography

This examination is indicated for all forms of astigmatism. By projecting rings onto the cornea (Placido discs) and measuring them using a computer, the doctor records the degree of astigmatism. The individual values of corneal refraction are measured in diopters and displayed in color on the display.

Corneal thickness measurement (pachymetry)

Pachymetry is performed to assess the indications for surgery. The thickness of the cornea is an indicator of the function of the internal pumping cells: the worse their function, the more the cornea swells and becomes thicker.

Corneal confocal microscopy (pump cell count)

High-resolution laser scanning of the cornea examines the internal pumping cells (endothelium) of the cornea. Endothelial cells do not regenerate and cell density decreases slowly over the course of life. Corneal microscopy is used to monitor the healing process after transplantation.

Optical coherence tomography of the anterior segment

The short-coherent light examination method provides high-resolution images of the cornea. OCT of the anterior segment:

• shows the individual layers of the cornea,
• calculates the thickness of the cornea,
• allows the doctor to determine the stage of the disease.

Correction of astigmatism

Depending on the type of astigmatism, the following treatments are possible:

• cylindrical lenses (glasses),
• contact lenses,
• laser correction,
• other operational methods.

Cylindrical and contact lenses

If the two focus lines combine to form a focus point, the image on the retina appears sharp. This function is performed by cylindrical lenses. When a person has farsightedness or myopia, cylindrical lenses are combined with spherical lenses. Contact lenses can allow for a higher degree of correction, but they often cause a lot of discomfort to the person.

Laser correction

The principle of these interventions is to compensate for ametropia by changing the refractive power of the cornea. Laser correction options:

• Lasik (Femto),
• Lasek (PRK),
• ReLEx smile.

Lasik

The most popular method of laser eye surgery is Lasik. It can be used to treat astigmatism up to five diopters. Removal is very accurate and guarantees a high level of security.
A very thin knife is used to cut the cornea — this creates a thin lid. It folds to the side and provides access to the deeper layers of the cornea. After a precisely calculated laser exposure, the flap is closed again.

Lasek

If Lasik cannot be used due to too small diameter of the cornea — PRK (Lasek) is used. With this method, only the thin epithelial tissue is dissolved before the laser is applied.

Disadvantages of Lasek: The healing process is slower and can be painful for several days after the procedure.

ReLEx smile

The procedure can compensate for astigmatism up to five diopters, but it is less effective than Lasik. The ReLex smile procedure is only beneficial for patients with dry eye syndrome.

Artificial lens implantation

If the cause of astigmatism is clouding or a change in the lens of the eye, surgical removal of the lens and implantation of an artificial lens is necessary. During cataract surgery, corneal astigmatism can be compensated for with special toric artificial lenses.

Keratoplasty

If there are scars or other changes on the surface of the cornea, a corneal transplant (keratoplasty) is performed. Different surgical techniques can be used depending on the type of defect.

Keratotomy

This surgical procedure is used to reduce severe astigmatism (from 5 diopters). At the edge of the cornea along the axis of the greatest bend, a deep arched incision is made (80% of the corneal thickness). This leads to relaxation of the corneal tissue along this axis — the curvature of the cornea decreases. Vision improves immediately on the second day after the operation, but for a full result you need to wait 2 weeks.