This method of astigmatism analysis enables the examination of results of astigmatism treatment measured by both refractive and corneal measurements using vector analysis. By examining individual vector relationships to the TIA (ie, the correction index, index of success, and flattening index), a comprehensive astigmatism analysis is completed. Each index provides information necessary for understanding any astigmatic change. Astigmatic outcome parameters are more favorable when measured by subjective refractive than objective corneal methods.

This method of astigmatism analysis recognizes the need to define an astigmatism goal, thus allowing the surgeon to obtain precise, separate measures of the magnitude and the angle of surgical error. From this, the surgeon can evaluate what surgery may be required to achieve the initial preoperative goal. An index that measures surgical success is adjusted for the level of preoperative astigmatism. The resulting data allow statistical comparison of multiple surgeries and techniques. This method also assists in resolving the case when spectacle and corneal astigmatism do not coincide.

Using vectors in astigmatism surgery enables the incorporation of topography and refractive values into the surgical plan. This would achieve a greater reduction in corneal astigmatism and potentially a better visual outcome than using refractive astigmatism values alone.

When treatment is applied off one of the four primary axes, the treating vector can be resolved into its component parts of flattening, steepening, and torque. Analyzing changes in this way provides a uniform means of assessing astigmatic changes for all types of cataract and refractive surgery and quantifies the flattening effect when treatment is applied off the intended meridian.

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