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- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: December 18, 2024
At Blue Fin Vision® Eye Clinic in London, we understand that the prospect of cataract surgery can be daunting. However, with modern advancements in ophthalmology, this procedure has become not only safer but also an opportunity to significantly improve your vision. One such advancement is the use of toric lenses during cataract surgery. In this comprehensive guide, we’ll explore what toric lenses are, why they’re used, and how they can benefit patients with astigmatism.
Understanding Cataracts and Astigmatism
Before we delve into the specifics of toric lenses, it’s important to understand the conditions they address: cataracts and astigmatism.
Cataracts
A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil. Cataracts are a common part of the ageing process and can cause blurry vision, glare, and difficulty seeing at night. When cataracts significantly impact your quality of life, surgery is often recommended to remove the cloudy lens and replace it with an artificial intraocular lens (IOL).
Astigmatism
Astigmatism is a common refractive error caused by an irregularly shaped cornea or lens. Instead of being perfectly round, an astigmatic eye is more oval-shaped, like a rugby ball. This causes light to focus on multiple points in the eye rather than a single point, resulting in blurred or distorted vision at all distances.
Many people have some degree of astigmatism, and it often occurs alongside other refractive errors like myopia (near-sightedness) or hyperopia (far-sightedness). Traditionally, people with astigmatism would need to wear glasses or contact lenses even after cataract surgery to achieve clear vision.
What Are Toric Lenses?
Toric lenses are a type of intraocular lens (IOL) specifically designed to correct astigmatism during cataract surgery. Unlike standard monofocal IOLs, which have a spherical surface, toric lenses have different powers in different meridians of the lens. This allows them to correct the uneven curvature of the cornea that causes astigmatism.
The term “toric” refers to the shape of the lens, which resembles a slice of the surface of a doughnut. This unique shape allows the lens to rotate to the correct position in the eye, aligning with the specific axis of the patient’s astigmatism.
How Do Toric Lenses Work?
Toric lenses work by compensating for the irregular shape of the cornea in eyes with astigmatism. Here’s how they function:
- Customised Design: Each toric lens is custom-made based on the patient’s specific degree and axis of astigmatism, as well as their overall refractive error.
- Precise Positioning: During surgery, the ophthalmologist carefully aligns the toric lens to match the unique astigmatism of the patient’s eye. Marks are often made on the cornea before surgery to guide this alignment.
- Stability Features: Toric lenses have special features, such as tabs or haptics, that help them stay in the correct position once implanted. This stability is crucial for maintaining the correction of astigmatism over time.
- Dual Correction: By correcting both the cataract and astigmatism simultaneously, toric lenses can significantly reduce or eliminate the need for distance vision glasses after surgery.
Why Are Toric Lenses Used in Cataract Surgery?
Toric lenses offer several compelling benefits for patients with astigmatism undergoing cataract surgery:
- Simultaneous Correction of Cataracts and Astigmatism
The primary advantage of toric lenses is their ability to address both cataracts and astigmatism in a single procedure. This means that patients can achieve clearer vision without the need for additional surgical interventions or reliance on glasses for distance vision.
- Improved Visual Outcomes
Patients who receive toric lenses often experience significantly better uncorrected distance vision compared to those who receive standard monofocal lenses. This improvement in visual acuity can greatly enhance quality of life, allowing for better performance in daily activities such as driving, reading, and watching television.
- Reduced Dependence on Glasses
While toric lenses primarily correct distance vision and astigmatism, they can dramatically reduce the need for glasses for many activities. Some patients may still need reading glasses for close-up tasks, but the overall dependence on corrective eyewear is often significantly diminished.
- Long-term Stability
Once properly positioned, toric lenses are designed to remain stable in the eye. This means that the correction of astigmatism is maintained over time, providing lasting visual benefits.
- Customised Treatment
Each toric lens is tailored to the individual patient’s eye, taking into account their unique degree and axis of astigmatism. This personalised approach ensures optimal visual outcomes for each patient.
Who is a Candidate for Toric Lenses?
While toric lenses offer significant benefits, they’re not suitable for everyone. Ideal candidates for toric lenses typically include:
- Patients with cataracts who also have regular astigmatism of 1 dioptre or more
- Individuals who desire reduced dependence on glasses for distance vision after cataract surgery
- Patients with healthy eyes, aside from cataracts and refractive errors
- Those who understand that they may still need reading glasses for near vision tasks
It’s important to note that patients with irregular astigmatism, certain eye conditions, or unrealistic expectations may not be suitable candidates for toric lenses. A comprehensive eye examination and discussion with an experienced ophthalmologist at Blue Fin Vision® Eye Clinic in London is essential to determine if toric lenses are the right choice for you.
Toric Lens Considerations
- Toric lenses cost more than standard lenses but provide better vision for patients with significant astigmatism.
- The improved visual outcomes often justify the additional cost for eligible patients.
The Toric Lens Implantation Procedure
The procedure for implanting toric lenses is similar to standard cataract surgery, with a few additional steps to ensure proper alignment of the lens. Here’s an overview of what you can expect:
- Pre-operative Measurements: Precise measurements of your eye, including the degree and axis of astigmatism, are taken using advanced diagnostic equipment. At Blue Fin Vision®, we use multiple systems to ensure accuracy:
- Biometry
- Corneal topography
- Autorefractor keratometry
The magnitude and axis of astigmatism are verified across these systems to ensure the most accurate calculation for your toric lens.
- Corneal Marking: Before surgery, the surgeon may place tiny marks on the edge of your cornea to guide the alignment of the toric lens.
- Anaesthesia: Local anaesthesia is administered to ensure you’re comfortable during the procedure.
- Lens Removal: A small incision is made in the cornea, and the cloudy natural lens is broken up and removed using ultrasound energy (phacoemulsification).
- Toric Lens Implantation: The folded toric lens is inserted through the same small incision and carefully positioned in the eye.
- Lens Alignment: The surgeon rotates the lens to align it precisely with your astigmatism, using the corneal marks as a guide.
- Incision Closure: In most cases, the small incision is self-sealing and doesn’t require stitches.
The entire procedure typically takes about 15-30 minutes per eye, and patients can usually go home the same day.
Recovery and Results
Recovery from cataract surgery with toric lens implantation is generally quick, with many patients noticing improved vision within a few days. However, it may take several weeks for your vision to stabilise completely as your eye heals and adjusts to the new lens.
During the recovery period, you’ll need to use prescribed eye drops to prevent infection and reduce inflammation. You’ll also have follow-up appointments with your ophthalmologist to monitor your healing and visual progress.
Most patients achieve excellent distance vision without glasses after toric lens implantation. However, it’s important to have realistic expectations. While toric lenses can significantly reduce astigmatism and improve distance vision, they don’t correct presbyopia (age-related difficulty with near vision). Therefore, you may still need reading glasses for close-up tasks.
Why Choose Blue Fin Vision® Eye Clinic for Your Toric Lens Surgery?
At Blue Fin Vision® Eye Clinic in London, we pride ourselves on offering state-of-the-art cataract surgery with toric lenses. Our experienced ophthalmologists use the latest technology and techniques to ensure optimal outcomes for our patients. We understand that every eye is unique, and we take a personalised approach to each case, carefully selecting the most appropriate lens and treatment plan for everyone.
Our commitment to excellence extends beyond the operating room. We provide comprehensive pre-operative counselling to ensure you understand all aspects of the procedure and have realistic expectations. Our dedicated team also offers attentive post-operative care to support your recovery and monitor your visual outcomes.
Conclusion
Toric lenses represent a significant advancement in cataract surgery, offering patients with astigmatism the opportunity to address both their cataract and refractive error in a single procedure. By reducing dependence on glasses and providing clearer vision, toric lenses can significantly enhance quality of life for many individuals.
If you’re considering cataract surgery and have been diagnosed with astigmatism, toric lenses may be an excellent option for you. However, the decision to use toric lenses should be made in consultation with an experienced ophthalmologist who can assess your individual needs and expectations.
At Blue Fin Vision® Eye Clinic in London, we’re committed to providing our patients with the highest standard of eye care. Whether you’re exploring your options for cataract surgery or have questions about toric lenses, we invite you to schedule a consultation with one of our expert ophthalmologists. Together, we can determine the best approach to help you achieve clear, crisp vision and improve your quality of life.
Remember, your vision is precious. Trust it to the experts at Blue Fin Vision® Eye Clinic, where cutting-edge technology meets compassionate care.
