Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum.  ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Eye Care Archive  (Expert Forum)
 | 
AcrySof Toric IOL
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Post a Question Back to Forum
MedHelp Member's Question

AcrySof Toric IOL

by Quill, Oct 03, 2006 12:00AM
I am a candidate for IOL in both eyes.  I have considerable astigmatism & my surgeon is suggesting the new AcrySof Toric lens.  However, I would be the first patient she is doing with this lens.  I would like any input from patients who have had this lens & the success rate.  I also have a high degree of presbyopia. Currently wearing custom toric soft lens with one eye for distance & one for intermediate.  Need to wear readers to read.  My dominant eye had optic neuritis 30 years ago so it is color blind & vision is not as sharp as it would have been.

When my optometrist tried monofocal contacts-using distance for right & close up for left-it did not work because of that domination.  Does work with intermediate in left though.

So I have some issues & am hesitant to be the first for the AcrySof although it sounds like it should really help me.

Thx
Doctor's Answer

by Forum-OD-MP, Oct 03, 2006 12:00AM
i dont think i have read any poster here having that particular implant, but i could be wrong.  hopefully someone will reply
Member Comments (11)

by hud, Oct 03, 2006 12:00AM
To: Quill
All I know is what I've heard about the acrysof Toric lens. If you have astigmatism, you are going to wear glasses or contacts with any standard implant. However, with the acrysof Toric, you may have a chance to be spectacle-free post-operatively for distance, depending on the amount of pre-existing astigmatism you have. Other surgical options are LASIK or corneal incisions, which are considered costly and unpredictable, respectively. If you go with a standard implant, you will need glasses for all activities. The proported advantages of the Acrysof Toric is that is does not move in the eye (negating the astigmatism correction), and it does have the extra retina protection from UV and blue light radiation. I have not heard of any downside of this lens.

by hud, Oct 03, 2006 12:00AM
To: Quill
All I know is what I've heard about the acrysof Toric lens. If you have astigmatism, you are going to wear glasses or contacts with any standard implant. However, with the acrysof Toric, you may have a chance to be spectacle-free post-operatively for distance, depending on the amount of pre-existing astigmatism you have. Other surgical options are LASIK or corneal incisions, which are considered costly and unpredictable, respectively. If you go with a standard implant, you will need glasses for all activities. The proported advantages of the Acrysof Toric is that is does not move in the eye (negating the astigmatism correction), and it does have the extra retina protection from UV and blue light radiation. I have not heard of any downside of this lens.

by JodieJ, Oct 03, 2006 12:00AM
To: Quill
The AcrySof Toric IOL just came out this year, so few surgeons have had much experience with it.  It was my surgeon's first choice for me, since it's supposedly a more predictable way to eliminate astigmatism than limbal relaxing incisions.  From the little I've read about it, it's an excellent lens which performs well and doesn't tend to rotate.  It's also considered a "premium" lens, and I was willing to pay the $1000 (per eye) out-of-pocket surcharge to get it.  Unfortunately, as it turned out, it didn't come in the power I needed.  But if you have only mild/moderate myopia and significant astigmatism, I think it would be an excellent choice.



As a second choice, you might consider the aspheric AcrySof IQ and limbal relaxing incisions, which worked very well for me.  I had two limbal relaxing incisions in each eye, which eliminated all my astigmatism, and my distance vision is now 20/20.  (I'm getting multifocal contacts for near/intermediate vision correction.)  But the best part is that my insurance picked up the entire tab, saving me about $25K!

by eyecu, Oct 04, 2006 12:00AM
The Acrysof Toric is not considered a premium lens nor does it have NTIOL status. LRI's have been used for many years with great results along with astigmatic laser correction.

by JodieJ, Oct 05, 2006 12:00AM
According to the literature, LRIs eliminate about 50% of preexisting astigmatism on average, with unpredictible results.  (I lucked out, although I've read that LRI results are sometimes prone to regression.) The AcrySof toric lens did much better than this in clinical trials.  There is an older toric IOL (made by B&L, I think), but surgeons have complained that it tends to rotate in the eye, thereby negating the astigmatism correction.  The AcrySof toric is reported to be more stable.



I don't know whether it's "official", but my surgeon considered the AcrySof toric to be a premium lens.  Its implantation does involve additional measurements and calculations.  Some surgeons charge an out-of-pocket fee for LRIs; others do not.  Laser vision correction post-surgery is certainly a reliable way of eliminating astigmatism, but I don't think any insurance will pay for it.  My surgeon charges about $2K per eye.



All things considered, I think the AcrySof toric lens would be an excellent choice for correcting significant astigmatism.  I think it would work well for a modified monovision correction (one eye set for distance, the other for intermediate vision).

by Quill, Oct 06, 2006 12:00AM
I spoke more with my optometrist who referred me to surgeon about whether the lens would rotate in the eye or does it remain fixed.  He said it has hooks on it! So it is fixed.

My biggest vision correction is presbyopia-focal point somewhere beyond the moon.

by JodieJ, Oct 06, 2006 12:00AM
To: Quill
The results of the clinical trials with the Acrysof toric lens suggest that it will elminiate most/all of your astigmatism, depending on the accuracy of your surgeon's calculations and the amount of astigmatism you have.  If you do a modified monovision correction like you have with your contacts, you should only need glasses for near vision.  I predict that you'll be pleased with the results.  Best of luck!

by Quill, Oct 11, 2006 12:00AM
OK.  I am still hoping to hear from someone who has had this lens implanted and their satisfaction level.

Thx

Quill

by Pandoraj, Nov 06, 2006 12:00AM
While the clinical trials outcomes on the Acrysoft Toric lens are exciting and hold great promise for astigmatic patients, it is important to remember that to date, these lens are NOT classified as "premium" lens by either Medicare or other payers, nor are they "new technology" lens.  



That means that CMS has not yet decided whether or not Medicare patients can be charged "extra" for the use of toric lens the way they can for presbyopic-correcting IOL's.

by big island, Nov 10, 2006 12:00AM
I also have a question/concern about the new toric implants to accommodate astigmatism.  I am in bad need of an implanted lens soon, as my nite driving is glary and with phantom images.  I am about to schedule surgery for early next year at Duke Eye Center.  My concern is that there is little information about the results of these implants (as another poster here expressed).



    My concern is exacerbated by me being a high risk patient, and so far all my eye 'issues' have led to poor results (two surgeries for a retinal detachment... this eye now has an implant....but I don't use the eye because (i) surgery left it out of alignment; (ii) my retina, re-attached, is no longer flat and vision is wavy;, and (iii) my implant on that eye clouded up in two days...but I have not had YAG to 'clean' it up because the cloudiness enables me to not have a secondary image interfering with my 'good' eye vision.  I get by with one eye, now producing nasty phantom images.



    My base-line feeling is to NOT fool with new types of lenses...keep matters simple and go with a 'standard' implant....as, based on my eye experiences, I'm likely to be the one for which the toric  will 'bomb', and I can't afford to have anything go wrong considering that I only use that one eye.  On the other hand, the doctor I selected for the surgery feels it is right for me to address the astigmatism issue (which is many diopters; I forgot exact number).  I'm also concerned that because this toric must be aligned perfectly, what are the chances of that happening or the lens slipping slightly out of place.  (I presently use a custom toric soft contact lens, so I know about 'out of alighnment'.)



   Any comments, suggestions, or first-hand information out there about toric implant lens to address astigmatism??  -- many thanks -- BI

by big island