Toric IOLs are an option for people who have cataracts and astigmatism.

It is very common for people to have astigmatism after and before cataract surgery. (Learn More) In the U.S., it is estimated that approximately one in three people who can have cataract surgery have some degree of astigmatism that causes noticeable vision problems. (Learn More)

There are different brands of toric IOLs to choose from. (Learn More) All of these are slightly different, so it is important to explore all the options before making a final decision.

Once a doctor determines that someone is a good candidate for toric IOLs, the next step is to perform the surgery. The doctor will remove the natural lens of the eye and implant a toric IOL. (Learn More)

What Are Cataracts?

young woman with cataracts

In the U.S., it is estimated that among adults ages 40 and older, over 24.4 million people have cataracts.

Under normal circumstances, the lens of the eye should be clear so vision is not obstructed. When someone has a cataract, the lens can appear cloudy or foggy. This causes images to appear hazy, blurry, or less colorful.

The following symptoms are possible with cataracts:

  • Seeing double in one eye
  • Not being able to see clearly at night
  • Blurry vision
  • Intense sensitivity to light
  • Bright colors have a yellow hue or appear faded

The most common cause of cataracts is aging. As people get older, normal eye changes occur that contribute to the formation of cataracts. This is characterized by lens proteins starting to break down.

Certain risk factors may increase the likelihood of cataracts, such as:

  • Family history of cataracts.
  • Previous eye injury, upper body radiation treatments, or eye surgery.
  • Corticosteroid use.
  • Diabetes and other medical problems.
  • A history of spending time in the sun, especially when the eyes were not protected by sunglasses.

What Is Astigmatism?

astigmatism vs normal vision graphic

Astigmatism is a type of refractive error that affects approximately one in three people in the U.S. It is common for people with astigmatism to also have other refractive errors, including nearsightedness and farsightedness.

When someone has astigmatism, their vision can appear distorted or blurry at all distances. When the condition goes uncorrected, headaches and eyestrain are common. These often occur with prolonged visual tasks or reading. It is also common for people to squint to try to see more clearly.

There are three primary astigmatism types.

  • Hyperopic astigmatism means that there is farsightedness in one or both principal meridians. If both meridians are affected, the hyperopic degrees can differ.
  • Myopic astigmatism means that there is nearsightedness in one or both principal meridians. If both meridians are affected, the myopic degrees can differ.
  • Mixed astigmatism is the third type. One meridian is farsighted, and the other is nearsighted.

What Are Toric IOLs?

multifocal intraocular lenses

In the past, intraocular lenses were not capable of correcting astigmatism when used to replace the lens removed during cataract surgery. At this time, the surgeon may have made incisions into the cornea to reduce the severity of the astigmatism. Toric IOLs changed this completely and gave people a viable treatment option for astigmatism.

Toric IOLs have things in common with toric soft contacts for astigmatism. In different meridians on the lenses, there are different powers. This helps to improve the eye’s asymmetric power, which occurs with astigmatism.

Comparing the Different Brands

The toric intraocular lenses that are FDA-approved include Abbott Medical Optics TECNIS Toric, Bausch and Lomb TRULIGN Toric, and Alcon AcrySof IQ Toric.

The TECNIS Toric lens promises the best low-light performance, sharpest vision, and long-term sustainability. It is used for those with astigmatism. Its power ranges from +5.0 to 34.0. It is made from a UV-blocking hydrophobic acrylic material.

The Bausch and Lomb TRULIGN Toric lenses work for astigmatism, presbyopia, and cataracts at the same time. This ensures a broader range of vision that is sharper and clearer. The manufacturer says that people get increased independence from their corrective lenses after getting these lenses implanted.

The Alcon AcrySof IQ Toric IOLs work for cataracts and astigmatism. They come in powers from +6.0 to 34.0. The seven-cylinder powers allow these lenses to treat preexisting corneal astigmatism. The manufacturer states that these lenses improve visual acuity and offer a decreased residual refractive cylinder.

Toric IOL Surgery

Surgeons performing an eye surgery under the microscope at the hospital - healthcare and medicine concepts

Implanting a toric lens for astigmatism is very similar to cataract surgery. The same general steps are used for both procedures. The surgeon removes the natural lens of the eye and replaces it with a toric IOL.

The surgery only takes about 15 minutes per eye and people are not put under general anesthesia. Before the procedure, eyedrops are used to anesthetize the eye, so the person does not experience discomfort during the procedure. Since only local anesthesia is used, it reduces the post-surgical recovery time in the hospital.

There are two surgical procedures the surgeon may perform to remove and replace the lens.

  • Extracapsular surgery removes the lens core in a single piece since the incision in the cornea is a little larger. This technique might be considered if the person has an advanced cataract.
  • Small incision cataract surgery uses a tiny probe and a small incision in the cornea. The probe sends ultrasound waves to the cataract to break up the lens. The doctor then suctions the pieces out. Sutures are usually not necessary for this technique.

Once the procedure is over, people will go to a recovery room for a short while. After this, most people are able to go home to continue recovery.

It may take up to a month for full recovery. The doctor will schedule follow-up visits at specific intervals to ensure the lens removal and implant recovery is going well.

The doctor often prescribes anti-inflammatory and antibiotic eyedrops after this procedure. This reduces inflammation and the risk of infection. During the first week of recovery, the eye may need to remain covered.

Before having the surgery, it is important to understand the potential complications. These may include the following:

  • Infection
  • Swelling
  • Dislocation of the artificial lens
  • Glaucoma
  • Inflammation
  • Bleeding
  • Eyelid drooping
  • Retinal detachment
  • Vision loss

Following your recovery instructions exactly can help to reduce the risk of these complications. Should any complications arise, immediately contact your doctor for further instructions.

With this information, you can make an informed choice about whether these IOLs are the best option for your astigmatism. Your doctor will perform a complete examination and ensure that your body and eyes are healthy enough for the procedure before replacing the lenses.

References

Astigmatism and Cataract? A Toric IOL and Fix Both. All About Vision.

Intraocular Lenses: How to Choose the Best IOL for Your Cataract Surgery. All About Vision.

TECNIS Toric IOL. Johnson and Johnson Vision.

TRULIGN Toric IOL. Bausch and Lomb.

Product Information: AcrySof IQ Toric IOLs. My Alcon.

Cataract Surgery. All About Vision.

Cataract Surgery. American Optometric Association.

How Long is the Recovery Time After Cataract Surgery? VisionAware.

Cataract Surgery. Mayo Clinic.

Eye Health Statistics. American Academy of Ophthalmology.

What Are Cataracts? American Academy of Ophthalmology.

Astigmatism. All About Vision.

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