Flipped axis astigmatism

[CBCT]

Prior to implantation of a Crystalens, my vision was -3.25 x -.25 x 162.   Now it is -2.25 x -1.25 x 10.  The result is disorienting.  Is this an excessive amount of surgically induced astigmatism?  Was my axis flipped?  What are the implications of a flipped axis?  Thanks.

[CBCT]

The surgery was performed in Dec. 2012.  I had YAGs in Feb and March in an effort to gain some accommodation, but there was not much improvement.    I am concerned that my surgeon is not forthcoming with information.  Is this amount of surgically induced astigmatism unusual?  Is this a case of flipped axis, and if yes, how does flipping an axis affect vision?

[Doreen Fazio, M.D.]

The answer depends on when the surgery was performed, and where the surgical incision was made.  If the surgery was very recent, the eye is still healing, and the astigmatism may change in a few weeks.  If the surgical incision was made at the first axis, say between 160 and 170 degrees, the incision may have flattened the cornea at that meridian and caused the axis to change to 10 degrees.  Ask your surgeon to obtain Keratometry readings to determine the true corneal astigmatism, and repeat the refraction in a while.  Also the surgeon should check to be sure the intraocular lens has not vaulted (Z syndrome), which may require a YAG laser procedure.