AcrySof Toric IOL - Surgeon experience question

[pinot88]

Hi-

I am a 49 year old male in need of a lens implant in one eye only as a result of a cataract accelerated by torn retinal surgery 2.5 years ago.

I am leaning toward the AcrySof Toric aspheric lens as I have astigmatism (2.25). I had a pre-op visit with one doctor & my decision comes down to a regular lens or the toric. The doctor was recommended to me (along with a few other options) by the opthalmologist that fixed my torn retina. I had a follow-up conversation today to ask a few more questions. The doctor is rather young & when I asked now many of the toric lens implants he has done, his answer was 10 (hundreds of regular implants).

His background & training seems top-notch, but I am a bit concerned about his limited experience with this lens. As much as I could do without another eye exam, I am thinking I should meet with one of the other recommended docs for a second opinion.

Thoughts would be greatly appreciated.

[Michael J Kutryb, MD]

Your options include a regular IOL and wear glasses for the astigmatism, or a regular IOL and LRI's for astigmatism or a toric IOL.  I charge much more for the toric IOL than for limbal relaxing incions so that often makes up some people's minds.  I would take some very careful measurements of your astigmatism to make sure you do indeed have 2.25 diopters.  At that level you could have LRI's or the toric IOL.  IF you felt uneasy about the toric IOL I might try to direct you more toward the LRI's which might be a simpler solution.  Even if you just reduced the astigmatism by half you would have a significant benefit.  If your surgeon has only done 10 torics, it might be a safer bet to go toward the LRI's if he is comfortable with that.  In my practice, I generally reserve the toric IOL's for astigmatism of 2.50 diopters and above so you can see that you are on the borderline.  Again, if you are nervous about the toric IOL, just go for LRI's instead.  Also, I hate to say it, but I would prefer thousands of implants rather than hundreds.  Experience matters to a tremendous degree (as well as skill and good decision making.)

MJK MD

[JodieJ]

Personally speaking, I'd get a second opinion.  You do sound like an excellent candidate for a toric IOL.

[pinot88]

Just wanted to report back on my surgery results. I had the implant done 8 days ago. I just went in for my second post-op visit & am now 20/20! The surgery itself was much easier to handle than the weeks of anxiety leading up to it.

So, I am currently wearing a contact in one eye & no correction needed in the "repaired" eye. I definitely need reading glasses for anything close-up. Now, I just have to decide if I want to do Custom Lasik on my other eye. It would be great to be free of contacts & glasses (except readers), but I am going to have to think about that one for a little while.

Overall, I am thrilled with the results!

[pinot88]

As a followup, I met with surgeon option #2 this morning. He has a lot more experience with the AcrySof toric implants & that is what he is recommending for me. Now, it's a matter of going without my contacts for a month or so & surgery is scheduled for February.

[pinot88]

DebraL-

Glad to hear of your great results. You mention having the lens implant in your left eye. What is the status of your right eye? Do you still wear a contact in that eye?

[DebraL581]

I had an Acry Sof Toric lens implanted in my left eye on October 26, 2009 and I'm extremely happy with the results.  I'm a 50 year old female, and prior to the surgery I was nearsighted (-10) with (2.50 diopters of astigmatism.  I'm now +0.75 with no astigmatism, as a result, I need reading glases for near vision i.e computer work and reading fine print; however my distance vision is perfect. I also wore gas permeable contact lenses for over 30 years. Prior to the initial measurement for my Acry Sof Toric lens I did not wear my contact lenses for three months. My ophthalmologist performs several cataract surgeries per week; however most of them are with the regurlar IOLs.  I suggest that you ask your surgieon for references from other patients who have had the surgery and are willing to share their experience with you.
DebraL581

[pinot88]

I do wear gas permeable contacts for 8-10 hours per day, so I guess I would need to not wear them for a month or so to get the most accurate astigmatism reading before the surgery.

I have an exam scheduled with a more experienced surgeon on Monday morning. I will report back.

Thank you JodieJ & Dr. Kutryb for the input.