Step 2: Surgical Planning for Toric IOL Implantation



The process for selecting the correct toric IOL is twofold:
1) Determine the required spherical lens power by using the preferred method and formula as with conventional IOLs and
2) Determine the magnitude, orientation and type of preexisting corneal astigmatism through keratometry and topography. Once you have captured the patient’s data, the toric calculator will help you determine the surgical plan and select the appropriate lens.

Any cataract surgeon can incorporate a toric lens into his or her practice easily. Besides maybe a toric marker set, all the tools the surgeon needs, he or she already has in the office."

Bonnie Henderson, MD*
Ophthalmic Consultants of Boston

*Dr. Henderson is a paid consultant for Alcon.

Using the Toric Calculator

The AcrySof® IQ Toric IOL Calculator allows you to select the appropriate toric IOL model and power. Designed to improve toric outcomes by helping you select and implant toric IOLs with accuracy, the toric calculator is an invaluable tool for developing your surgical plan.

Try the AcrySof® IQ Toric IOL Calculator

Learn more about how to use the AcrySof® IQ Toric IOL Calculator.

Learn more about how to use the AcrySof® IQ Toric IOL Calculator.

Learn more about how to use the AcrySof® IQ Toric IOL Calculator.

Dr. Tipperman is a paid consultant for Alcon.

Toric calculator basics

Once you have taken biometry measurements and determined your SIA, you can use the ALCON® Online Toric IOL Calculator to select the proper toric lens. In addition to calculating the toric IOL model, it helps to determine and illustrate the angle of implantation to simplify alignment of the IOL on the steep axis. The calculator also shows the magnitude and axis of anticipated postoperative residual astigmatism. The results can be printed and taped to the microscope mount as a visual reference for use during surgery. See a sample output screen of the ALCON® Online Toric IOL Calculator below**.

Toric calculator data output screen

Incision placement can affect your lens selection and, in some cases, the residual astigmatism. To see how this applies, try inputting different incision locations into the AcrySof® IQ Toric IOL Calculator, keeping all other input data the same.



**Sample data used for illustration only.

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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).