Step 1: Toric IOL
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
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.
This topography reading shows a normal eye with no astigmatism.
A good toric IOL candidate will have regular symmetrical astigmatism, appearing as a "bowtie" or “figure-eight” pattern on the topography.
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.
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.
This topography reading shows an irregular astigmatism. This type of irregular astigmatism should not be treated with a toric lens.
An asymmetric astigmatism, or keratoconus, is shown above. This is a type of irregular astigmatism that should not be treated with a toric lens.