Eyeworld

EW FEATURE 106 Current and future IOL choices • March 2018 AT A GLANCE • There are various toric platforms available to help correct astigmatism, and for patients with higher astigmatism than can be addressed by the torics, a combination with LRIs or other techniques may be used. • Surgeons may want to use caution in patients with irregular astigmatism, as they may not be the best candidates for toric IOLs. by Ellen Stodola EyeWorld Senior Staff Writer Experts discuss toric IOLs available in the U.S. and specifics for implanting them T oric IOLs can be a good option to correct astigma- tism in a variety of patients, with several different lenses available. Michael Green- wood, MD, Fargo, North Dakota, Russell Swan, MD, Bozeman, Montana, Edward Holland, MD, Cincinnati, and Lawrence Wood- ard, MD, Atlanta, discussed current toric IOLs, how to correct for higher astigmatism, and other approaches to using torics. Current IOLs to correct astigmatism in the U.S. Dr. Greenwood said there are a number of toric IOL options avail- able to help correct astigmatism. Alcon (Fort Worth, Texas) has the AcrySof toric IOL that can correct up to 4 D of astigmatism at the spectacle plane; Johnson & Johnson Vision (Santa Ana, California) has the Tecnis toric lens that can also correct up to 4 D; and Bausch + Lomb (Bridgewater, New Jersey) has its Trulign platform, which is similar to the Crystalens with the pseudo- accommodating platform but also a toricity of about 2 D at the spectacle plane. Additionally, Dr. Greenwood said Alcon makes multifocal toric IOLs, and Johnson & Johnson Vi- sion has the Symfony toric. "We have access to all of them at our center," he said, adding that he uses whichever is best for each individual patient. In a patient who will get a monofocal toric, Dr. Greenwood leans toward the Alcon platform because he said there are a couple of studies that show rota- tional stability is a little better. "All of the options are good," he added. If a patient is looking for more independence from glasses, Dr. Greenwood said multifocal or extended depth of focus IOLs are good options. "I talk to patients and see what kinds of activities they do where they want freedom from glasses." The Alcon multifocal toric, Using toric IOLs to correct astigmatism AcrySof Toric IOL Source: Alcon Monthly Pulse Current and future IOL choices EyeWorld Monthly Pulse is a reader survey on trends and patterns for the practicing ophthalmologist. Each month we send an online survey covering different topics so readers can see how they compare to our survey. If you would like to join the physicians who take a minute a month to share their views, please send us an email and we will add your name. Email carly@ eyeworld.org and put "EW Pulse" in the subject line. Which of the following would you like to see in future IOLs? Improved presbyopic corrections Reduced aberrations Postoperative adjustability All of the above With respect to corneal astigmatism and toric IOLs: I would use a toric IOL to help correct astigmatism >0.75 D and above I would use a toric IOL to help correct astigmatism >1.25 D and above I do not use toric IOLs

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