Toric Intraocular Lenses (IOL)
What is a Cataract?
Most people believe that a cataract is a growth that is growing over or inside the eye. A cataract is a clouding of the natural lens located behind the pupil inside the eye. The word Cataract comes from where water in a river becomes white or cloudy in rapids (cataracts) or water falls. A ripe cataract is when the lens turns white and on close observation you could see that the person has a white pupil.
When Should I have Cataract Surgery?
Most people today with modern cataract surgery do not wait until their cataracts become ripe or mature. At that point your vision is so bad that you cannot see your hand in front of your face. The reason for having cataract surgery is that you are unhappy with your vision and it is interfering with your daily activities or lifestyle. You also need to meet the Medicare and insurance company guidelines for having cataract surgery. It is also important that the eye surgeon feels that it will improve your vision and that there are not any eye diseases that would keep you from improving your vision.
What About Astigmatism and Cataract Surgery?
Astigmatism that can be corrected during cataract surgery comes from the shape of the cornea (clear portion in front of the eye). The cornea is shaped more like a football cut length wise in a person with astigmatism. The person without astigmatism has a cornea that is shaped like a basketball cut in half. When light is focused through the cornea without astigmatism, the light is focused to a clear point. When light is focused through a cornea with astigmatism, the light is focused to a line versus a clear point. This is the reason people with astigmatism will see a streak coming from lights at night. Your glasses or contacts are able to correct the astigmatism so that you can see clearly.
If you have a significant amount of astigmatism such as over one diopter, you will see blurred after the cataract surgery unless you wear glasses to correct the astigmatism. Just like glasses, there are intraocular lenses that can correct the astigmatism during the cataract surgery.
Cataract surgery is the removal of your cloudy lens (cataract) and replaced with a clear artificial lens (intraocular lens). The eye surgeon will use sophisticated instruments that measure your eye and provide the doctor with the strength of intraocular lens to correct your vision. These instruments are very accurate and will recommend a lens that will correct you vision for distance in most cases.
Cataract Surgery with Toric or Astigmatism Correcting Intraocular Lenses
If you wish to have good vision without glasses for distance and have significant astigmatism, you will need a toric or astigmatism correcting lens used during your cataract surgery. The eye doctor uses the measurements that are taken from your eye and puts the information into a special formula from the companies that make the toric intraocular lenses. This formula will print out the strength of toric lens that matches your eye. The location or axis of the irregular cornea is used to place the lens at the proper degree of axis. It needs to be placed at that axis in order to correct the astigmatism. If you have astigmatism correction in your glasses and turn your frame, you will see that your vision blurs. Once the lens is placed inside the eye inside the capsule that held your natural lens, the axis marks on the lens are rotated into the proper alignment. In a very few cases, the lens can rotate inside the capsule within the first day or two. The lens can be rotated back into its correct axis.
Brands of Toric Intraocular Lenses
AcrySof® Toric Intraocular Lenses
There are two types of lenses made by Alcon, the AcrySof IQ Toric and AcrySof Aspheric IQ Toric lenses. These lenses are available in a wide selection of powers.
Staar® Toric Intraocular Lenses
Staar also makes toric intraocular lenses used during cataract surgery.
Cost of Toric Intraocular Lenses
The costs associated with having toric intraocular lenses used for correcting astigmatism, are not covered by Medicare or insurance companies. They do not consider correcting astigmatism as medically necessary. They will cover the cost of having the cataract removed as with a regular type of intraocular lens. The additional cost of the toric lens used to correct the astigmatism to decrease the need for glasses is not covered. The cost varies around the country and from eye surgeon to eye surgeon. The typical range is from $900.00 to $1,700.00 per eye. The freedom from glasses and being able to wake up and see without glasses is well worth the cost for many people. The typical pair of bifocal glasses can cost from $200.00 to $700.00. You can use over-the-counter reading glasses after surgery which cost $5.00 to $25.00. By the time you buy 2 or 3 pairs of glasses, you have covered a large portion of the cost and you have the decrease dependence on glasses.
If you have a significant amount of astigmatism and desire to see well after cataract surgery with the least dependence on glasses for distance, toric intraocular lenses are an excellent option.