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Astigmatism Management: Inside the Mind of the Cataract Refractive Surgeon Moderator Robin Vann, MD, is in academic practice at Duke Eye Center, Durham, North Carolina. He can be contacted at robin.vann@ duke.edu. Faculty Bonnie An Henderson, MD, is in private practice at Ophthalmic Consultants of Boston, Waltham, Massachu- setts. She can be contacted at bahenderson@eyeboston.com. John Berdahl, MD, is in private practice at Vance Thompson Vision, Sioux Falls, South Dakota. He can be contacted at johnberdahl@gmail.com. John Hovanesian, MD, is in private practice in Laguna Hills, California. He can be contacted at jhovanesian@harvardeye.com. Today's cataract surgery patients often desire as much freedom from spectacles as possible. If our goal is to provide optimal postop outcomes for patients in this new era, astigmatism management needs to be part of the cataract surgeon's procedural mindset for every patient, at every stage. Robin Vann, MD: I'm pleased to have an incredible pan- el of experts here to discuss a topic we're all passionate about as cataract surgeons—astigmatism management. This is a phrase used frequently in our specialty, but without a consistent definition. As such, depending on experience or perspectives, this will mean very different things to different people. Often the term "astigma- tism management" is used in conjunction with specific techniques or technologies being discussed. With our specialty increasingly shifting a focus toward "refractive outcomes," discussions around the latest techniques or technologies for managing astigmatism are certainly warranted, but often overlook the most important vari- able in the equation—the surgeon's mindset. What does "astigmatism management" mean to cataract refractive surgeons? How do they view its role in their surgical procedures? How might their perspective differ from "traditional" views of cataract surgery? Although all of the experts here have unique experienc- es, preferences, and techniques for managing astigma- tism at the time of cataract surgery, their fundamental passion, understanding, and respect for this topic is the shared denominator we wanted to explore in this dis- cussion. Fundamental changes in our specialty are not driven by technology; change starts with the surgeon. The mindset we share on this topic—viewing astigma- tism management and cataract surgery as inseparable functions—is one we arrived at from different routes. Many residency programs today are now embracing this view, but the majority of cataract surgeons in practice did not have this type of initial training and are having to evolve their mindset and approach to astigmatism in practice. This discussion is intended to put specific technolo- gies and brands aside in order to dive deeper into the thought-leaders' mindset on astigmatism management. In doing so, we hope to help others who may be looking to better understand astigmatism management's posi- tion and importance in the "outcomes era" of cataract surgery. This supplement was produced by EyeWorld and sponsored by Alcon. The doctors featured in this supplement received compensation from Alcon for their contributions to this supplement. Copyright 2016 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or the publisher, and in no way imply endorsement by EyeWorld or ASCRS.

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