Update on astigmatism management

PURPOSE OF REVIEW: Astigmatism is a common refractive error that affects a significant portion of the population. This is a review of the most salient topics on assessing astigmatism as well as a discussion of the latest developments in surgical options and newest technologies to improve outcomes. RECENT FINDINGS: Laser corneal ablation continues to be highly effective for correcting low-to-moderate levels of astigmatism and may be the best option for the younger patient population. For eyes with astigmatism and cataracts, both peripheral corneal-relaxing incisions and cataract extraction with toric intraocular lenses have proven to be effective. Improved assessment of astigmatism, methods to select more accurate lens power, and new technologies to confirm proper axis alignment have all contributed to minimizing postoperative residual astigmatism. SUMMARY: Cataract surgery has evolved into a refractive procedure, in which not only the sphere but also cylinder errors can now be confidently corrected. Careful assessment and surgical planning of astigmatism should not be an option, but essential components of cataract surgery.