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Are Toric Lens Implants Worth It?

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Last Updated

Toric lens implants are a valuable option for patients with significant astigmatism undergoing cataract surgery. While more expensive than standard IOLs, they offer precise correction of astigmatism, improved visual acuity, and reduced dependence on glasses or contact lenses. 

The right lenses for you will depend on your vision needs, personal preferences and budget. It’s always best to discuss your options and needs with a specialized surgeon to find the right match.

What Are Toric IOLs?

Toric intraocular lenses (IOLs) are specialized intraocular lenses designed to correct astigmatism during cataract surgery or refractive lens exchange surgery.

intraocular lenses

If you have astigmatism, the curve of your eye is slightly imperfect. Rays of light entering your eye aren’t focused in one spot on the back of the retina. Instead, they’re spread out and don’t quite hit the retina in the right spot. Blurry vision results.

During cataract surgery, doctors don’t change the front of your eye to correct astigmatism. Instead, they implant a toric lens, which has a unique shape that compensates for the irregular curvature of the cornea.. The result is crisp, sharp vision. 

What is the cost of toric lenses for cataract surgery?

As with many other things in the vision care world, the cost of IOLs depends on where you live, your surgeon, and your insurance plan. You can generally expect to pay between $2,500 and $4,000 per eye considering also the cost of the lens.

How Do Toric Lens Implants Work?

Toric IOLs are technical tools made for talented ophthalmic surgeons. If your doctor thinks you need a toric IOL, they will measure your eye and design the lens accordingly. Here’s how the process works:

Measurement and Calculation

Before surgery, the eye surgeon takes precise measurements of your eye to determine the correct power and orientation of the toric lens implant needed to correct the astigmatism. 

Toric Lens Design

Toric lenses are shaped like a rugby ball, with different powers in different meridians to compensate for the irregular curvature of the cornea characteristic of astigmatism.  Doctors must understand your astigmatic axis and place the lens precisely along that meridian, often leveraging special tools to determine that axis. Toric lenses come with markers on the peripheral parts of the lens, allowing your doctor to see the ideal correction and rotate the lens accordingly.

Implantation

During surgery, the surgeon positions the toric lens implant in a specific orientation to neutralize the astigmatism from the cornea.

Correction

The toric lens implant refracts light evenly onto the retina, resulting in sharper vision and reduced dependence on glasses after surgery.

Long-Term Results

Toric lens implants are designed to be a permanent solution for astigmatism correction, ensuring long-term vision improvement

Available Toric Lens Options

FDA-approved toric IOLs include:

  • Abbott Medical Optics TECNIS Toric
  • Bausch and Lomb TRULIGN Toric
  • Alcon AcrySof IQ Toric.

What Are the Advantages of Toric IOLs?

If you’ve grabbed glasses for decades to do everyday things like make a grocery list or read the morning paper, toric IOLs could be right for you.  Studies show that people with astigmatism can see better with toric IOLs after surgery than can people with traditional monofocal IOLs.  Toric IOLs offer several advantages, including:

  • Precise astigmatism correction: Corrects irregular corneal curvature.
  • Improved visual acuity: Enhances sharpness and clarity of vision.
  • Reduced dependence on glasses: Reduces need for glasses or contact lenses.
  • Customizable: Available in various powers and sizes for individual needs.

These benefits make toric IOLs a valuable option for patients with astigmatism undergoing cataract surgery or refractive lens exchange surgery.

What Are the Disadvantages of Toric IOLs?

Toric IOLs provide several advantages, but there are some factors you should keep in mind before going ahead with the surgery:

  • Additional Cost: Toric IOLs are considered premium lenses, so they are not covered by regular insurance.
  • Single-Focus Lens: Like monofocal IOLs, toric IOLs are single-focus lenses and do not provide perfect vision at all distances. Reading glasses may still be necessary.
  • Limited Customization: While toric IOLs are customizable, they are not as versatile as some other types of IOLs, such as multifocal or accommodating lenses.

Toric IOL Side Effects

The side effects of toric intraocular lenses (IOLs) are generally rare and manageable. Reported side effects include:

  1. Astigmatism Overcorrection or Undercorrection: The toric IOL may not fully correct the astigmatism, resulting in some residual astigmatism.
  2. Dislocation or Rotation of the IOL: In about 3 percent of cases, people need a lens adjustment, because the Toric IOL must be precisely placed in order to properly correct vision. 
  3. Glare and Halos: Some patients may experience glare, halos, or starbursts around lights, especially at night.

These side effects are generally rare and can be managed with proper surgical technique and patient selection.

When is a toric IOL not recommended?

While you might want a toric IOL, your doctor might not recommend them. Eyes with severe astigmatism caused by a condition like keratoconus might not be right for these types of lenses.

Does Medicare Approve Toric IOLs?

Original Medicare plans cover traditional lenses and the surgeries needed to implant them. If you choose a toric IOL, your traditional Medicare plan won’t cover the cost of the lens or the surgery. 

If you want to use toric IOLs and you’re using traditional Medicare, tell your doctor before the procedure starts. You’ll need to work out payment plans.

Some people use Medicare Advantage plans, purchased through a health insurance company, to get better health care coverage. These plans could cover toric IOLs and their surgeries, but you’ll need to read the fine print to be sure.

Toric IOL Frequently Asked Questions

What is the success rate of toric IOL?

Researchers say toric IOL success rates range between 70 percent and 80 percent. Newer surgical methods, including those that involve lasers, could make that success rate even higher.

Is a toric lens worth the cost?

It depends. If you’d like to reduce your dependence on glasses, paying a little more for these lenses could be appropriate for you. If your budget is tight and your glasses are covered by insurance, getting a standard lens might seem like the right choice.

How long does it take to adjust to this type of lens?

Experts say it can take up to six months to get used to your new lenses. If you’re struggling to see clearly, talk with your doctor and ensure your eyes are healing properly.

How long does a toric lens last?

Your new cataract lens will last a lifetime, and you don’t need to do anything to maintain it.

Can I get a Toric Lens if I don’t have cataracts?

If you have astigmatism but no cataracts, you can still benefit from a Toric IOL by having a Refractive Lens Exchange Surgery (RLE). The procedure is very similar to cataract surgery. It only takes about 15 minutes per eye, and general anesthesia is not required.

References

  1. Toric IOLs: Myth Versus Reality. (September 2013). Cataract and Refractive Surgery Today.
  2. Toric Intraocular Lenses: Expanding Indications and Preoperative and Surgical Considerations to Improve Outcomes. (January 2022). Indian Journal of Ophthalmology.
  3. Toric IOLs: Nailing the Target Meridian. (February 2017). Review of Ophthalmology.
  4. Six Messages Your Glasses May Be Sending People. (February 2016). Psychology Today.
  5. Clinical Differences Between Toric Intraocular Lens (IOL) and Monofocal Intraocular Lens (IOL) Implantation When Myopia Is Determined as Target Refraction. (May 2021). BMC Ophthalmology.
  6. Optimizing Outcomes With Toric Intraocular Lenses. (December 2017). Indian Journal of Ophthalmology.
  7. Maximizing Your Toric IOL Outcomes. (January 2020). Review of Ophthalmology.
  8. Medicare Vision Services. (August 2021). Centers for Medicare and Medicaid Services.
  9. Toric Intraocular Lens Outcomes With a New Protocol for IOL Selection and Implantation. (February 2018). JFO Open Ophthalmology.
  10. Handling the Unhappy Premium IOL Patient. (May 2018). Review of Ophthalmology.

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