A toric intraocular lens is designed to correct pre-existing corneal astigmatism at the same time as cataract surgery, for patients whose cornea is not evenly curved.
What Is It?
Astigmatism occurs when the cornea (or, less commonly, the lens) is curved unevenly, causing blurred or distorted vision at all distances rather than at just one. A standard (spherical) IOL does not correct this unevenness.
A toric IOL has additional, specific optical power built into it to counteract a measured amount of corneal astigmatism. It is positioned at a precise axis inside the eye during cataract surgery.
Toric IOLs are considered for patients who already need cataract surgery and who also have a measurable, regular degree of corneal astigmatism confirmed on pre-operative testing.
Symptoms & Indications
Astigmatism is usually identified during a routine eye examination or the biometry testing done before cataract surgery, rather than through symptoms alone.
Unlike simple short- or long-sightedness, astigmatism can blur vision both near and far, along with a cataract's own blurring.
Keratometry or corneal topography during your pre-cataract work-up shows a meaningful, regular amount of astigmatism.
Patients who have long worn glasses with a cylindrical ('CYL') correction often have corneal astigmatism worth addressing at surgery.
Patients who want clearer uncorrected distance vision after cataract surgery, rather than continuing to rely on glasses for their astigmatism.
Treatment Options
Corneal curvature is measured to confirm the amount and axis of astigmatism before deciding on a toric lens.
The correct implantation axis is marked and verified during surgery so the toric lens sits in the planned orientation.
In suitable eyes, toric correction can be combined with certain multifocal/EDOF lens designs — assessed on a case-by-case basis.
What To Expect
Toric IOL surgery follows the same core steps as standard cataract surgery, with extra measurement and alignment steps specific to astigmatism correction.
Corneal curvature, axial length and astigmatism axis are measured in detail before surgery.
The correct axis for lens alignment may be marked on the eye before the procedure.
The cataract is removed and the toric IOL is implanted and rotated into the planned axis.
Vision and lens position are reviewed at follow-up visits; in rare cases, a lens may need repositioning if it rotates from the planned axis.
Please note: Toric IOL suitability depends on having regular (not irregular) astigmatism and healthy corneal and retinal findings. Irregular astigmatism from conditions such as keratoconus may need a different approach, discussed individually.
Common Questions
Evaluated and treated under Dr. Deepak Gandhi, Director of Gandhi Eye Centre, with clinical experience across cataract, glaucoma, cornea, retina and pediatric eye care.
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