EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/233841
February 2011 January 2014 Ease of implantation One reason for the appeal of onepiece lenses like the AcrySof and Tecnis IOLs is that they are traditionally easy to insert and position. The Tecnis Toric has relatively stiffer haptics that let it open in a controlled fashion. A nice feature is that it can be rotated clockwise or counterclockwise. This reduces intraoperative manipulation and allows fine-tuning of the axis position without having to dial the IOL close to 180 degrees if I miss my mark initially. The Trulign has an entirely different delivery system, of course. Many surgeons feel that it is technically more challenging. The capsulorhexis must be sized perfectly. The lens can't be vaulted anteriorly or positioned too far posteriorly and the anterior chamber must be absolutely stable, so implantation of this lens does require a certain degree of skill. Surgeons who are comfortable implanting the Crystalens will be comfortable implanting the Trulign as well. The inserter for this lens also requires a larger incision (2.85 mm) than either of the onepiece lenses. We are fortunate to have four toric IOL options now in the U.S. market. These are all good lenses; cataract surgeons should understand the features and relative advantages of each in order to best meet the visual needs of our astigmatic patients. EW References 1. Ma JJ, Tseng SS. Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation. J Cataract Refract Surg 2008;34(10):1631-6. 2. AcrySof IQ Toric Product Information, 2009. Alcon Laboratories. 3. Chang DF. Early rotational stability of the longer STAAR toric intraocular lens: fifty consecutive cases. J Cataract Refract Surg 2003;29(5):935-40. 4. Chua WH, Yuen LH, Chua J, et al. Matched comparison of rotational stability of 1-piece acrylic and plate-haptic silicone toric intraocular lenses in Asian eyes. J Cataract Refract Surg 2012;38(4):620-4. 5. Terwee T, Weeber H, van der Mooren M, Piers P. Visualization of the retinal image in an eye model with spherical and aspheric, diffractive, and refractive multifocal intraocular lenses. J Refract Surg 2008;24(3):223-32. 6. Zhao H, Mainster MA. The effect of chromatic dispersion on pseudophakic optical performance. Br J Ophthalmol. 2007;91:1225-9. Editors' note: Dr. Matossian is founder and CEO of Matossian Eye Associates, a private integrated ophthalmology and optometry group practice with three offices in Pennsylvania and New Jersey. She is clinical instructor, Department of Ophthalmology, Temple University School of Medicine, Philadelphia. Dr. Matossian has financial interests with Abbott Medical Optics. EW REFRACTIVE SURGERY Contact information 33 Matossian: cmatossian@matossianeye.com