To Toric or not to Toric

[indecider]

I am scheduled for cataract surgery and astigmation correction on Monday, 12/14/09.  Doctor is recommending limbal relaxing incision.  But I went for a second doctor's opinion, who, after exam, recommended a Toric IOL set for 0.50 for 2.2 diopters of astigmation.  Don't know what to do.  Advice?

[indecider]

Thank you so much.  My concern is that one doctor says I have 1.3 astigmatism on the cornea and the other doctor measured 2.2 on the cornea.  A 2.2 astigmatism, according to the second doctor, would be better resolved with a Toric lens.  I went back to the first doctor and he retook the measurement, again coming up with 1.3.  He's suggesting LRI.  I'm more comfortable with the first doctor; I just don't understand how they can come up with two very different measurements.

[Sandy Feldman, MD, MS]

Dear indecider,

These are two different methods of approaching the same issue. I recommend that you undergo the procedure with the doctor with whom you feel most comfortable.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[JodieJ]

Is there a typo in your post?  You said that you can't see clearly clearly from 4 feet to 100s of feet (with both eyes?), yet you can see far distances (with both eyes?)

It sounds like your right eye might be farsighted.  Is everything within 4 feet blurry using only your right eye?  Do you know the glasses/contact prescription for your right eye post-surgery?  Is the same surgeon planning on operating on your left eye on Monday?  If so, I might be inclined to cancel the surgery and go with doc #2.

[indecider]

Thank you so much for your quick and thoughtful response.  I want to avoid glasses as much as possible.  Had cataract surgery and LRI on R eye, but now - even with L contact lens- I can't see clearly from about 4 ft to 100's of feet (can't see people until they are on top of me, can't see faces on the street, etc.), which is a change from pre-surgery and driving me crazy.  I can see far distances the same as before.  So I want to be able to see clearly beyond my own nose,and not sure what my best options are.      

[JodieJ]

If the cost of the toric IOL is not a deterrent and you are highly motivated to reduce your need for glasses, I'd go with the toric IOL (as long as the surgeon is experienced with it.)  Research shows that a toric lens does a better job of eliminating astigmatism in the 2.2 diopter range.

What are your goals for your post-surgery vision?  A target of -.50 would probably give you about 20/40 uncorrected distance vision (if astigmatism were eliminated) and a little (uncorrected) intermediate vision.  This would please some people but not others.