I need the first question answered, which is....one top surgeon recommends a toric in one eye to correct an astigmatism
his tec says they've taken 4 measurements and 3 out of 4 say I should have a toric correction in one eye and a monofocal in the other. My second opinion, another top surgeon says his tests register so little that he would not put a toric in one eye, just monofocals. I don't know which Dr. to go with.
One question is.....if I went with a toric and really didn't need it, is there adverse side effects, or am I just out the $.
Might a toric tweek my vision just enough to help me not have glasses.
Thanks....surgery is coming up and I'm the runaway bride again. Should I get a 3rd opinion?
You'll have to go with whomever you feel most comfortable with on this one, or get a third opinion if you're really torn. However, let me throw out a couple of other possibilties.
A small amount of astigmatism would probably not cause your vision to be impaired much with a monofocal lens -- it would be just like a pair of eyeglasses that have been adjusted for your refraction correction, but not your astigmatism. Before your surgery, you might ask your surgeon to let you try a contact lens for the eye with the small amount of astigmatism. If you have the lens correct only your refraction and not your astigmatism, you should get an idea of what your correction would be like with the non-toric monofocal.
I'm not sure whether either of your prospective surgeons mentioned this to you, but nother possibility might be limbal relaxing incisions, assuming your surgeon is experienced with and comfortable with doing them, They could be done either during your cataract surgery or afterwards. LRI's are quite safe, and are usually pretty effective in correcting small to moderate amounts of astigmatism.
As for your question regarding adverse side effects with the toric IOL, it does need to be placed in the right position to correct astigmatism. There is a slight possibility that this IOL can shift post-operatively, thus compromising the astigmastism correction. This used to be an issue with earlier toric IOL's, but my understanidng is that this risk is much less with the latest generation of the toric IOL by Acrysof.
Other than that, there is really no more risk than there is with a standard non-toric monofocal.
In your place, I would get a copy of my eye measurements from each office. If the results are not almost identical (as they should be), I'd have my eyes measured again at a third office. If the measurements from each office are about the same, I would request that someone from each office sit down with me with both sets of measurements and explain the basis for their recommendations. (I'd probably do some research about technical recommendations for toric IOLs beforehand. All the information you'd need is available online, and it's really not too difficult to understand. This way you could have a role in determining what your new vision will be.)
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