Helping Patients Understand the Value of Toric Lenses
Nearly three-fourths of the population has astigmatism >0.5 D, and in such cases, you are best served using toric lenses, be they multifocal or single-focus, noted John A. Hovanesian, MD, an eye surgeon at Harvard Eye Associates in Laguna Hills, CA, during OSN New York 2018.
Your choices include:
- Trulign Lens (2.75): Approved May 2013
- Symfony Toric (2.57D): Approved July 2016
- ReSTOR 3.0 Toric (2.06D): Approved December 2016
- Active Focus 2.5 Toric (2.06D): Approved May 2017
To help the patient understand the value of such a lens, ask if they ever wore monovision contact lenses (one eye for near, one eye for distance). And ask them if the experience was satisfactory.
Among those who choose to receive the lens, ~ 9 in every 10 are satisfied with their vision 5-plus years later, said Dr. Hovanesian. Satisfaction rates among the different lens types are similar.
As for imperfect eyes, including those who have dry eye, epiretinal membrane, keratoconus, or previous radial keratotomy, consider single-focus lens (monofocal or accomm ± toric), he explained. Also, err on side of myopic outcome, which allows for easier enhancement.
Dr. Hovanesian summed up by noting that toric options are available now for nearly every presbyopia-correction scenario. He added that you should:
- Consider acceptance of monovision as first decision branch.
- Consider visual desires and the general health of the eye.
- Use all available options: multifocal, EDOF, accommodating, and monofocal lenses.
- Follow up after surgery to confirm the goal has been reached.
Hovanesian J. Choosing an approach for presbyopic correction in the astigmatic cataract patient. Talk presented at: OSN New York 2018; September 28-30, 2018; New York.