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A B C

Figure 1. Kershner-Location and architecture of clear corneal arcuate astigmatic incisions. Reprinted from: Kershner, RM. “Clear Cornea Cataract Surgery and the Correction of Myopia, Hyperopia and Astigmatism.” Ophthalmology 1997;104:381-389.

a. Single, clear corneal 2.5 mm planar, stab incision on the oblique or temporal limbus for astigmatic neutrality.

b. Single, clear corneal 2.5 mm arcuate incision on the steepest axis at the 10mm optical zone to correct 1 D or less of astigmatism or a single 3.0 mm arcuate incision on the steepest axis at a 9 mm optical zone, to correct 1-2 D of astigmatism.

c. Two arcuate keratotomy incisions are placed according to the nomograms to correct greater than 2 D of astigmatism.

Figure 2. Kershner-Comparison of preoperative best corrected and postoperative uncorrected visual acuity. n=690. Reprinted from: Kershner, RM. “Clear Cornea Cataract Surgery and the Correction of Myopia, Hyperopia and Astigmatism.” Ophthalmology 1997;104:381-389.

Figure 3. Kershner- Comparison of preoperative and postoperative refractive sphere (D). Reprinted from: Kershner, RM. “Clear Cornea Cataract Surgery and the Correction of Myopia, Hyperopia and Astigmatism.” Ophthalmology 1997;104:381-389.

Figure 4. Kershner-Comparison of preoperative and postoperative

refractive cylinder (D). Reprinted from: Kershner, RM. “Clear Cornea

Cataract Surgery and the Correction of Myopia, Hyperopia and

Astigmatism.” Ophthalmology 1997;104:381-389.

Figure 5. Kershner-Preoperative topography shows an ideal candidate for refractive correction with cataract surgery.

Figure 6. Kershner-A disposable Clear Cornea Incision System (BD) can be used to create the ideal corneal incisions for cataract surgery.

Figure 7. Kershner-The globe may be stabilized when making the incision with a disposable fixation ring.

 Figure 8. Kershner-The proposed incision is marked at the proper steepest + meridian.

Figure 9. Kershner-A single-plane incision is best for astigmatic neutrality.

Figure 10. Kershner- A two-step incision starting with a vertical groove maximizes flattening with the cataract incision.

Figure 11. Kershner-Incisions placed into the cornea flatten in the meridian in which they are placed.

Figure 12. Kershner Corneal astigmatism can be neutralized with an arcuate keratotomy incision.

Figure 13. Kershner - The toric intraocular lens can correct astigmatism by aligning the two marks on the IOL with the steep meridian.

Figure 14. Kershner-The intraocular lens is always aligned with the steep meridian while injecting into the capsular bag.