When considering premium surgeries and high expectations from patients along with an unrelenting quest for vision exceeding 20/20, the tolerance of residual astigmatism must be zero. Like bespoke tailors, ophthalmologists need to be bespoke surgeons who tailor vision in each eye to the highest level possible. We cannot claim to design the best suit using the best technology and tailoring materials, and yet, in our minds, find it “acceptable” to have the suit length within a half-inch to three-quarters of an inch too short or wide.
Some patients are unhappy even with Snellen visual acuity of 20/20 or better. While it may sometimes be tempting to dismiss these patients as unreasonable or “crazy,” understanding what makes these patients dissatisfied even with good Snellen visual is important for their proper management, says Daniel H. Chang, MD.