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M anagement of astigmatism at the time of cataract or refractive lens surgery has evolved to include arcuate keratotomy and toric intraocular lens (IOL) implantation. Integration of preoperative corneal diagnostic instrumentation via Streamline digital wireless connectivity to the LENSARTM femtosecond laser (LENSAR Inc., Orlando, FL, US) now allows improved precision and accuracy of arcuate incision and toric IOL alignment, eliminating a significant source of error in astigmatism correction. Use of a pre-programmed, surgeondefined nomogram for arcuate incision construction, based on transmitted data from preoperative corneal analysis, permits further efficiency and reduction of transcription error. Toric IOL alignment is currently facilitated with IntelliAxisTM (LENSAR Inc., Orlando, FL, US) corneal marks. Management of astigmatism at the time of cataract surgery provides the refractive benefit of reduced dependence on glasses and sets the stage for correction of presbyopia

Management of Astigmatism with the LENSAR Laser System with Streamline