80 | EYEWORLD | DECEMBER 2020
R
EFRACTIVE
He added that while the IC-8 pinhole IOL
(AcuFocus) is not yet FDA approved, there is
hope for its use in patients with irregular astig-
matism.
If there is significant irregularity, Dr. Lee
said he mentions the possibility of wearing a
rigid gas permeable contact lens during the
preop consultation.
"I explain that no IOL can correct an irreg-
ular cornea perfectly and that choosing a toric
or adjustable lens means closing the door on a
rigid gas permeable lens, practically speaking,"
he said.
and wait 3 months before retaking measure-
ments for cataract surgery.
Causes of irregular astigmatism that are
untreatable are keratoconus, post-refractive
ectasia, and pellucid marginal degeneration. Dr.
Swan said some stable keratoconus or pellucid
marginal degeneration that has non-skewed
astigmatism in the central 6-mm zone could
still respond well to a toric lens. It goes without
saying that a limbal relaxing incision would not
be appropriate for these patients, he added.
"The defining questions to ask are 1) is it
stable and 2) have they gotten good vision in
glasses, historically, or did they need to be in a
scleral lens or a rigid gas permeable lens. If they
had to be in a hard contact lens, your likelihood
of success with a toric is very low," Dr. Swan said.
continued from page 78
Contact
Berdahl: john.berdahl@
vancethompsonvision.com
Lee: bryan@bryanlee.pro
Ristvedt: deborah.ristvedt@
vancethompsonvision.com
Swan: russell.swan@
vancethompsonvision.com
Wiley: wiley@cle2020.com
In partnership with leading academic institutions
ASCRS is pleased to announce a new effort to bring
the best and brightest in ophthalmic teaching to
members. ASCRS Grand Rounds is a virtual,
complimentary CME offering exclusive to ASCRS
members that brings the experience of a live
grand rounds to your home or office.
ASCRS has partnered with major academic institutions
to present a monthly series of virtual grand rounds,
each approved for 1.0 AMA PRA Category 1 Credit™.
View during a pre-scheduled time to engage with the
speakers or view on-demand at your convenience.
Visit ascrs.org to view the
2021 ASCRS Grand Rounds schedule.
Terry Kim, MD Sumitra Khandelwal, MD
Moderators
