Cataract surgery with pseudo-exfoliation and astigmatism

I am 74 years old and need catarct surgery.  My right eye has pseudo-exfoliation and corneal astigmatism of about 1.0.  I am leaning towards a standard IOL with an LRI.  My surgeon says a toric lens would be more predictable to correct the astigmatism.  He says the  toric lens is about 90% effective in reducing/eliminating  astigmatism while the LRI is only 50%.   I am, however, very concerned about the risk of rotation later on due to the pseudo-exfoliation.  I understand that there is a risk of depositioning with any lens, but a simple rotation with a standard lens would probably not be problem.  With a toric lens, rotation would definitely create a problem.   My right eye has virtually no astigmatism, and I will be using a standard IOL.  Does anyone have any thoughts about the toric vs. an LRI in cases like mine with pseudo-exfoliation?

[Houman Vosoghi, MD]

Depends how much you care to be glasses free for distance after the cataract surgery.  If you don't mind having a 50% chance of needing glasses, then a standard lens should be fine with LRI.  If you want to take a chance on later rotation/movement of the lens for a 90% shot at being glasses free for distance now, you also have your answer.  Personal preference.

HV