When a cataract-clouded lens is removed, it needs to be replaced by an artificial lens. These are called intraocular lenses (IOLs). Prior to 2005, patients had to choose a single distance where these artificial lenses would focus, either distance or near. The patient would then wear glasses to correct the vision distance not addressed by the monofocal lenses, usually for up close vision.
In 2005, the first multifocal IOLs came to market. This type of IOL provides correction for both near and distance vision, much like your eyes normally would. Both near and far objects can now be in focus at the same time without the use of glasses.
Toric Intraocular Lenses
Then in 2006, “toric” lenses were introduced. In the past, IOLs could not correct astigmatism in cataract surgeries. Astigmatism is where the eyeball is more oval shaped than round which creates focusing problems at certain distances.
Toric IOLs have different powers in different meridians of the lens to correct the asymmetric power of the eye, the tenets of astigmatism. Special markers are located on the peripheral parts of the Toric lens. This shows Dr. Sondheimer where the orientation of the lens needs to be placed onto the eyeball. Once the IOL is implanted in the eye, Dr. Sondheimer rotates the lens to align the lens to match the astigmatism markers.
What Is a Toric Monofocal IOL?
Toric monofocal IOLs correct astigmatism, but provide only one distance of optimal focus, either far or near. Patients choose which distance they prefer to have in focus, and correct their vision with eyeglasses for the other. The difference between a monofocal IOL and a toric monofocal IOL is the astigmatism correction.
Toric Monofocal IOLs Benefits
If you have astigmatism, it means that the cornea or natural lens of your eye is shaped oblong like a football instead of spherical like a basketball. Astigmatism distorts vision at distance, intermediate and near. The distortion ranges from low to profound. Toric Intraocular Lenses after cataract surgery correct the astigmatic distortion of light giving clearer vision without corrective lenses. With a Toric IOL, you may be able to stop wearing eyeglasses altogether or reduce your glasses usage to non-prescription reading glasses. Toric IOLs are available in monofocal, extended depth of focus, and trifocal forms, giving several enhanced options to correct vision correction for people with astigmatism. Some patients choose toric iol monovision, where one eye sees well in the distance and the other eye sees well at near. The brain intergrates vision from both eyes and often gives excellent vision in both eyes without the need for corrective lenses. The Light Adjustable Lens is another technology to correct astigmatism. Dr. Sondheimer helps each patient understand the many vision correction options available with cataract treatment and helps each patient choose the best option.
Monofocal IOLs still require correction for whichever vision distance you choose not to correct. However, they allow for the patient to have perfect or sharper vision at their chosen distance rather than improved vision at both distances. These lenses are also less expensive than toric multifocal IOLs.
How Can I Know if Toric IOLs Are the Right Fit for Me?
If you have been diagnosed with astigmatism and are preparing for cataract removal surgery, Dr. Sondheimer may present a Toric lens as a replacement option. The Light Adjustable Lens is another technology that can correct astigmatism during cataract surgery. Many patients don'e require astigmatism corrrection. During your consultation, Dr. Sondheimer will carefully evaluate your lenses, astigmatism, retinal health, and goals. Together, you and Dr. Sondheimer will choose the best vision rehabilitation option for you. Your new intraocular lens should improve your vision for the rest of your life. We, we want to get it right and help you select the best vision rehabiltation option for your needs and desires.
How Long Will it Take to Adjust to My Toric IOLs?
Most patients adjust to their Toric IOLs rapidly as their vision improves days after having cataract surgery. The cataract surgery can cause blurriness that usually improves after a few days. Most patients enjoy clearer, crisper vision through their new toric intraocular lens, within days after having cataract surgery.
What is the Success Rate of Toric IOLs?
According to research, the results of cataract removal and Toric lens insertion are excellent. Recent improvements in Toric IOL calculations and alignment have given better and better vision after cataract surgery with Toric IOLs. The Light Adjustable Lens gives the most precise astigmatism correction. Rarely Toric IOL's need to be surgically repostioned or replaced to give the best vision without glasses.
What Should I Expect After My Cataract Replacement Surgery with Toric IOLs?
After your cataract surgery you should that colors appear more vibrant and bright, because you are seeing through a clear lens. You should notice better contrast and be able to see finer details. After surgery, many patients are surprised that they had not noticed the gradual and subtle loss of vision that their catarcts had caused. Most patients, who do not have decreased vision potential from other eye problems such as macular degeneration, recover the abiltiy to see to drive at night and read fine print.
Are There Risks Associated with Toric IOLS?
Like most surgeries, cataract removal and the insertion of a Toric Intraocular lens has risks. About 1 of 200 patients do not recover good vision after cataract surgery. Very rarely, patients can go blind after cataract surgery. Some patients have less potential to see well after cataract surgery because of macular degeneration, glaucoma, or corneal diseases. Toric IOL's can be mispositioned during surgery and can rotate out of position after surgery. Rarely, Toric IOLs need to be surgically rotated or replaced.
Candidates for Toric Multifocal IOLS
If you have astigmatism, and prefer not to have to wear glasses for close up work such as reading or working on the computer, toric multifocal IOLs could be a great option for your cataract replacement lenses. These lenses may or may not return you to 20/20 vision, but they will likely deliver accurate enough vision that you will no longer need any eyeglasses.
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What Is a Toric Multifocal IOL?
Toric multifocal IOLs also correct astigmatism but provide correction for both near and distance vision. This allows objects at both near and far to be in focus at the same time. It will take some time for your brain to learn how to process this new visual information. After adjusting most patients no longer need eyeglasses. Toric multifocal IOLs also correct for presbyopia which mostly occurs in adults over 40.
Intraocular Lens Options
Both monofocal and multifocal IOLs, toric or not, have different characteristics depending on the brand. Dr. Sondheimer will discuss your options with you during your consultation. He will explain what each brand does differently with their individual products to help you make the right choice for your lifestyle.
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Toric Multifocal IOLS Benefits
These lenses allow most people to be free from eyeglasses. They allow you to correct vision far away, close up, and all distances in between. People who have these toric lenses find they can be glasses-free, except for very fine print. This can vary by patient, but people do appreciate not having to wear reading glasses for most situations.
Candidates for Toric Monofocal IOLS
Four out of 10 Americans have significant amount of astigmatism, so these IOLs are a good option. People in professions such as airplane pilots or others that require excellent distance vision may opt for these toric monofocal IOLs, knowing they will have to wear reading glasses for near vision.