Chapter 10: Toric Implants

Toric Implant, Astigmatism correction, toric IOLs, refractive surprise post surgery There has been a lot of talk about toric IOL’s and they have certainly become more popular in ophthalmology in recent times. When do you use toric IOLs in your practice? My approach to treating corneal astigmatism at the time of cataract surgery depends on the amount of preoperative corneal astigmatism. Less than 1 D I will use the phaco incision by placing it on the steep corneal meridian. Between 1-2 D I use limbal relaxing incisions and greater than 2D I use toric IOLs. How do you plan for the most accurate toric IOL? It’s all about the accuracy of the toric IOL calculator used. It must incorporate: • The total corneal power • The axial length of the eye • Personalised IOL constants to calculate the effective lens position • Adjustment of the IOL toricity for the spherical component of the IOL when converting to the corneal plane Which calculator do you use when planning toric IOL selection? Well the Assort Toric calculator encompasses all the concepts that we have discussed, plus others which could be found at www.Assort.com, This calculator is free to use and includes the total corneal power, the Abulafia-Koch adjustment and a long eye adjustment for increased accuracy.