ABSTRACT Implantation of phakic intraocular lenses for refractive purpose is a safe and efficient elective surgical alternative. This option should be considered to electively treat ametropia when laser corneal refractive surgery has higher risk of complications, either due to corneal characteristics or the magnitude of ametropia. This article provides a prospective review of the phakic lenses available in the Brazilian market in 2020 and their characteristics.

High astigmatism correction represents a challenge for the refractive surgeon with current available technology. Excimer laser correction should be considered as an option in the available therapeutic arsenal. We report a patient with astigmatism higher than eight diopters to whom it was used a treatment with LASIK (Laser Assisted In Situ Keratomileusis) in two surgical moments, using a new generation of excimer laser with an optimized aspheric profile.

Preexisting corneal astigmatism, present at the time of cataract surgery, is reviewed in detail throughout this article on its most important aspects such as occurrence rates, clinical relevance and current treatment options. Special emphasis is given to the latter aspect. Each method’s rationale, advantage and limitation ishigh lightened. Comparisons between treatment options, whenever possible, are also provided.