toric lens

[naoye]

I'm scheduled for cataract surgery next month and was very sorry and dismayed to read about the difficulties Laura4 has had after her surgery.

My cataract surgeon has recommended the acrysof toric lens to me as well.  I mentioned to him my apprehension after reading the posts by Laura4.  His opinion is that these difficulties unfortunately can occur with any type of IOL and are not more prone to occur with the toric lenses.  (He also mentioned that, if Laura4 was going to change the lens, she should try one from a different manufacturer because they all have different ways of making their lenses and a different method may be more suited to her eyes.)

Because my 1.5 D astigatism is on the borderline for the toric lens, I think he would be willing to use an aspheric lens with limbal relaxing incisions, although he says that the LRI are not very precise and sometimes grow back in.

I would really appreciate any futher thoughts regarding the toric lenses.  At this point, I'm leaning towards the aspheric lenses because being conservative seems less scary.  (The cataract surgery is being done mainly because pyterigia in both eyes have made it very uncomfortable to wear contact lenses and glasses don't correct my high myopia very well.  An ERM peel will probably be done on the right eye soon after the cataract surgery, so the cataract would have progressed quickly in any case.)

Thank-you very much.  This is a great forum - for the information given and shared and for encouraging people to keep looking for solutions.  

[John C Hagan III, MD, FACS, FAAO]

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[JodieJ]

What recommendations did the second opinion doctor have for you?  Did he know what might be responsible for your dysphotopsia?

[naoye]

You must be relieved to receive some good news about the feeling of imbalance.  I hope it will be helpful to you in deciding whether to replace the toric lens.

With respect to Dr. Hagen's comments about astigmatism, is it possible that measuring this is not an exact matter?  I'm wondering this because you might be concerned about possibly being over-corrected.  

(The cataract surgeon told me about a week ago that my right eye had 1.5 D. astigmatism but the optometrist said today that it is 2.0 D.  However, in my case this could be because retinal scarring makes it difficult for me to answer consistently - when they ask which of two lenses give a better picture.)

[John C Hagan III, MD, FACS, FAAO]

If you have .8 diopter of astigmatism and you put a 1.5 in the eye you will be over corrected by .7 diopter. SO you are not a candidate for a toric IOL.  By putting the surgical incision on the steep axis of the cornea, making the incision a little wider than usual and using a lot of steroid eye drops the surgeon should be able to cure about .5 diopters.

JCH III MD

[Laura4]

I saw my 2nd opinion doctor yesterday and I he said that the word aberration - which I've been using - is mostly used with problems following lasek surgery.  What I have is negative dysphotopsia (just the dark shadow on temporal side of vision), and positive dysphtopsia (the glare, halos, light flickering) and then the now existing imbalance between eyes which causes some of the wet look.  This last part was encouraging since it will be possible to correct the imbalance.  

Just trying to improve my technical language here.  Dr. John, hope my understanding is correct.

I have one other technical question.  If the lowest powered Toric lens has a 1.5 correction, what does that mean for someone with only ,80 diopter of atigmatism.  I now have the correct number for my pre surgical astigmatism.  That's nothing compared to what Jodie has been describing.  

Laura4

[naoye]

Thank-you, Jodie.  That's very helpful.
I also agree with the red flag in relation to toric lenses based on what Laura's doctors have said.