Toric IOLS

[Carol1315]

I am facing cataract surgery in the next few months.  My surgeon has recommended monovision iols since I am accustomed to monvision contact lens.  My left eye will have the distant iol and has .86 astigmatism.  My right eye will have near iol and has no astigmatism.  Should I request a toric iol for my left eye?

[John C Hagan III, MD, FACS, FAAO]

The toric IOL has been much more successful than the multifocal IOLs. May drawback is there is about $1000-1600 out of pocket extra costs.

JCH MD

[Carol1315]

Thank you for your quick response.  I will check with my surgeon about the incision possibility.  He told me before I was measured that he recommended to most of his patients to go with the AcylSof toric lens with 1.0 or larger measurement.  Because I said I wanted crisp distant vision, he told me he would use the .75 as a guideline for me.  After getting measured, the technician told me that my left eye was .86 and that I could go with a standard or toric lens.  What do you recommend to your patients?  Is there a downside  to the toric lens?  My main goal is to go without glasses as much as possible.

[John C Hagan III, MD, FACS, FAAO]

Obviously you would need to discuss that with your surgeon. If the astigmatism is "against the rule" that is axis 180 the surgeon can often correct the astigmatism by putting the surgical incision in the steep axis, and using steroid drops longer than usual.

JCH MD