At the recent AUSCR meeting in Ayer’s rock, I meet and spoke with Dr Warren Hill who is considered a world expert in cataract surgery. We spoke in some detail about cataract surgery planning for patients with significant astigmatism requiring the implantation of a toric lens. He convinced me to use the Zeiss Atlas 9000 as he suggested that axis determination was far more accurate than our current method. Specifically, he advocated using the Atlas to determine the true cylinder axis and the setting this information on our manual, Javal Schiotz keratometer. Thus the keratometer would be set at the axis indicated by the Atlas and a K1 reading obtained then re-measuring the K2 at 90 degrees to that. This would give me the cylinder power which would then be plugged in to our lens calculation formula as it only requires the magnitude. The axis would then be used in toric aligment intraoperatively.
This meeting with Warren has proved expensive as my practice has added an Atlas to our armamentarium.