Trying to decide toric or not

[BaurPwr]

I am 54 years old. I have cataracts in both eyes. I am schedule for surgery in two weeks. I have astigmatism in both eyes. The doctor is recommending toric lenses so I will have optimal distance and crispness but will have to wear reading glasses. The cost for the torics is $1100 each (on top) and no insurance coverage - a real reach for me financially.  I use a computer all day and a cash register weekends. Wearing my contacts (gas perms) today I have to wear reading glasses and while in the car I have to use them to see the dash, car clock, etc. I can't see my cell phone without them or even put on make up (oh no!!) . No contacts, I wear glasses and just look under or over or remove when I need to read or see up close.
Because my of my up close vision requirements I wonder if I should go with the Toric. If I go with the "standard" lens can I still wear gas perm contacts? I am afraid to make the wrong decision.

So bottome line:

Toric or standard ... inquiring minds want to know.

Any advice would be appreciated. Thanks!

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

You're welcome.
JCH MD

[BaurPwr]

Thank you!!

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

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[BaurPwr]

Thank you ! After wearing my contacts for a couple of days and realizing how cranky they get by the end of the day I believe I will go with the Torics.

Thanks !!

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

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[Craig10x]

I agree 100% with Jodie...if its a level of astigmatism that could be corrected with limbal relaxing incisions, then that wouldn't be a bad way to go...but if it is a LOT (like i had) then toric is likely the best answer...get a second opinion for sure...

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

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[JodieJ]

How much astigmatism do you have?  If it's less than a diopter, I'd recommend skipping the toric.  You might consider getting a second opinion--perhaps limbal relaxing incisions could alleviate some/all of your astigmatism for a lot less money.  If you have significant astigmatism, the toric IOL might be worth the additional expense, depending on your personal priorities.

[Craig10x]

You should keep in mind that if you have astigmatism, and don't get toric lenses, you will have to wear glasses for everything (including distance/midrange)...

Best bet is torics with perhaps mini-monovison which should optimize your distance and mid range, and then you would need glasses mostly for close reading...

I have astigmatism and got torics and had to pay $1300 per eye for the difference over what the insurance company pays...it was worth every penny...

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

You should be sure that you ask your MD how long to leave out your GP CTL before the measurements are done before surgery to determine the corneal curviture which in turn determines IOL power and toric axis.  Going 2 weeks would be ideal and making two determinations to see if they're consistent.

This has been discussed at length and you can access the discussions searching toric IOL, mini-monofocal IOL choice.

Since money is a problem MOST people (you will need to decide yourself) go for monofocal IOLs and plan on wearing no line bifocals some or all the time. You can also research using IOLs and a mini-monofocal near bias or distance bias.

JCH MD