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Toric Lens Implants for Astigmatism
A toric lens implant corrects astigmatism at the same time it replaces your cataract, so you get clear distance vision without glasses in one surgery. At Insight Eye Center in Mentor, Dr. Michael E. Rom measures your astigmatism before surgery, aligns the lens to it during the procedure, and follows your healing afterward.
What is a toric lens implant?
A toric lens implant is a foldable monofocal intraocular lens with astigmatism correction built into its shape. It is placed during cataract surgery exactly like a standard lens, but it is chosen and aligned to counteract the uneven curve of your cornea, so distance vision is sharp without glasses. Near vision is not corrected; reading glasses are still needed.
Astigmatism means the cornea is curved more steeply in one direction than the other — shaped more like the back of a spoon than a ball — so light focuses at two points instead of one and vision is blurred or distorted at every distance. A standard lens implant cannot correct that; glasses can. A toric lens corrects it inside the eye.
Dr. Rom currently uses the enVista® Toric lens from Bausch + Lomb, which is made to correct astigmatism including low amounts. It has the same biocompatible material as the standard enVista lens.
Who is a candidate for a toric lens?
A toric lens is for people who have a cataract and a meaningful amount of corneal astigmatism, and who want clear distance vision without glasses afterward. The measurements taken before surgery — corneal topography and optical biometry — show the amount and direction of your astigmatism and tell Dr. Rom whether a toric lens, or incisions at surgery, is the better way to correct it.
Mild astigmatism is often better treated with limbal relaxing incisions during the same procedure. Larger amounts usually respond better to a toric lens, and in some cases Dr. Rom combines the two. If your astigmatism comes from an irregular cornea rather than a regular curve, a toric lens may not be suitable; the exam shows that too.
Limbal relaxing incisions — mild corneal astigmatism, placed during cataract surgery.
Toric lens implant — more significant astigmatism, built into the implant itself.
Both — occasionally, to fully correct larger amounts.
How is a toric lens implanted?
The surgery is standard cataract surgery: numbing drops, a tiny incision, ultrasound to remove the clouded lens, and the folded implant placed in the lens capsule. The difference is alignment. A toric lens has to sit at the exact angle of your astigmatism, so Dr. Rom rotates it into position using the plan built from your measurements.
- MeasurementsCorneal topography and optical biometry map the curve of your cornea and the length of your eye. The lens power and the toric axis are calculated from these numbers.
- PlanningThe surgical plan records the angle at which the lens must sit. Insight Eye Center uses ZEISS planning and alignment technology for this step — see VERACITY and CALLISTO eye.
- SurgeryThe cataract is removed as usual and the toric lens is placed in the capsule, then rotated to the planned axis.
- RecoveryThe same as standard cataract surgery: a next-day check, drops for a few weeks and a few short restrictions. Distance vision sharpens as the eye heals.
What results can I expect from a toric lens?
Most patients with a toric lens see clearly in the distance without glasses once the eye has healed — driving, television and faces are sharp. Near vision is not corrected by a toric monofocal lens, so reading glasses are still needed for close work. A small residual astigmatism is possible and can usually be fine-tuned with glasses or, occasionally, a minor procedure.
You return to the Mentor office the day after surgery for a check, with a few more visits as the eye settles. If the second eye needs surgery, it is scheduled a few weeks later.
I saw Dr. Rom for cataract surgery with additional elective LRI surgery. I could not have asked for a better outcome with these surgeries. Dr. Rom is exceptional at what he does; his staff also is very helpful and efficient.Grace F. · cataract surgery with astigmatism correction
Common questions about toric lenses
Short answers to the questions patients ask most often. For anything specific to your eyes, ask Dr. Rom at your visit or call the office at (440) 286-1188.
Does a toric lens fix astigmatism completely?
It corrects the regular corneal astigmatism measured before surgery. Most patients end up with little or none, but a small residual amount is possible and can be managed with glasses if it bothers you.
Is a toric lens covered by Medicare or insurance?
The cataract surgery is covered, subject to your deductible and coinsurance, but the toric lens is an out-of-pocket upgrade because astigmatism correction is considered elective. The office gives you the cost before you decide.
Will I need reading glasses with a toric lens?
Yes, for close work. A toric monofocal lens is set for distance. If you would like less dependence on reading glasses, ask about extended-range lens options.
Can a toric lens rotate after surgery?
Rarely. Modern toric lenses are designed to stay in position once the capsule heals around them. If a lens does rotate enough to affect vision, it can be repositioned in a short procedure.
Is the recovery different from standard cataract surgery?
No. Recovery is the same: a next-day check, prescribed drops for a few weeks, and no swimming, hot tubs or heavy lifting for about two weeks.
Cataracts and astigmatism? One surgery.
Request a cataract evaluation with Dr. Rom in Mentor. The measurements taken at the visit show whether a toric lens or incisions at surgery will correct your astigmatism.
