Step 1: Toric IOL
Patient Identification

A patient’s preoperative visit is your first opportunity to educate them about advanced technology lens options and the benefits of toric IOLs. Understanding how to select ideal patients for toric lenses and learning tips for talking with your patients about treatment options will set up your toric procedures for patient satisfaction and surgical success.

Before I even pick up the chart, my attitude is that every patient may be a candidate for astigmatism reduction. Why? Because I’m a refractive cataract surgeon, and my goal is clear, uncorrected vision.”

Robert Osher, MD*
Professor of Ophthalmology,
University of Cincinnati

*Dr. Osher is a paid consultant for Alcon.

Types of Astigmatism

Corneal topography plays a very important role in evaluating patients for toric IOLs. It helps you assess corneal curvature, evaluate astigmatism, monitor corneal disease and detect irregularities in corneal shape. In the case of toric implants, topography readings provide a quick picture to help you determine which patients qualify for a toric IOL.

Normal eye

Corneal topography of normal eye without astigmatism

This topography reading shows a normal eye with no astigmatism.

Toric candidate

Corneal topography showing regular astigmatism

A good toric IOL candidate will have regular symmetrical astigmatism, appearing as a "bowtie" or “figure-eight” pattern on the topography.

With-the-rule

Corneal topography of with-the-rule astigmatism

This topography reading shows with-the-rule astigmatism, a condition in which the steepest corneal meridian is at the vertical plane versus the horizontal. With-the-rule astigmatic patients are good candidates for toric IOLs.

Against-the-rule

Corneal topography of against-the-rule astigmatism

This topography reading shows against-the-rule astigmatism, a condition in which the steepest corneal meridian is at the horizontal plane versus the vertical. This patient would also be a good candidate for a toric IOL.

Irregular

Corneal topography showing irregular astigmatism

This topography reading shows an irregular astigmatism. This type of irregular astigmatism should not be treated with a toric lens.

Asymmetric/Keratoconus

Corneal topography showing asymmetric astigmatism

An asymmetric astigmatism, or keratoconus, is shown above. This is a type of irregular astigmatism that should not be treated with a toric lens.

Test Your Knowledge

Are you ready to recommend toric IOLs in your practice?

Take the Quiz
View Important Product Information for
AcrySof® IQ Toric IOL+

ACRYSOF® IQ TORIC INTRAOCULAR LENSES IMPORTANT PRODUCT INFORMATION

CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.

INDICATIONS: The AcrySof® IQ Toric posterior chamber intraocular lenses are intended for primary implantation in the capsular bag of the eye for visual correction of aphakia and pre-existing corneal astigmatism secondary to removal of a cataractous lens in adult patients with or without presbyopia, who desire improved uncorrected distance vision, reduction of residual refractive cylinder and increased spectacle independence for distance vision.

WARNINGS/PRECAUTIONS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Toric IOLs should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. All viscoelastics should be removed from both the anterior and posterior sides of the lens; residual viscoelastics may allow the lens to rotate.

Optical theory suggests that high astigmatic patients (i.e., > 2.5 D) may experience spatial distortions. Possible toric IOL related factors may include residual cylindrical error or axis misalignments. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof® IQ Toric Cylinder Power IOLs.

Studies have shown that color vision discrimination is not adversely affected in individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS® or BSS PLUS® Sterile Intraocular Irrigating Solutions.

ATTENTION: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions.

Click here to view the AcrySof® IQ Toric IOL Directions for Use (DFU).

ACRYSOF® IQ TORIC INTRAOCULAR LENSES IMPORTANT PRODUCT INFORMATION

CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.

INDICATIONS: The AcrySof® IQ Toric posterior chamber intraocular lenses are intended for primary implantation in the capsular bag of the eye for visual correction of aphakia and pre-existing corneal astigmatism secondary to removal of a cataractous lens in adult patients with or without presbyopia, who desire improved uncorrected distance vision, reduction of residual refractive cylinder and increased spectacle independence for distance vision.

WARNINGS/PRECAUTIONS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Toric IOLs should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. All viscoelastics should be removed from both the anterior and posterior sides of the lens; residual viscoelastics may allow the lens to rotate.

Optical theory suggests that high astigmatic patients (i.e., > 2.5 D) may experience spatial distortions. Possible toric IOL related factors may include residual cylindrical error or axis misalignments. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof® IQ Toric Cylinder Power IOLs.

Studies have shown that color vision discrimination is not adversely affected in individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS® or BSS PLUS® Sterile Intraocular Irrigating Solutions.

ATTENTION: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions.

Click here to view the AcrySof® IQ Toric IOL Directions for Use (DFU).