Custom Astigmatic (Toric) Surgery

Written by Schulze Eye & Surgery Center on July 8, 2016. Posted in Cataract Surgery

In order to understand Custom Astigmatic Surgery, it is important to have a good understanding of astigmatism. An eye without astigmatism is essentially round, like a basketball. Eyes with astigmatism have a shape more like the surface of a football or an egg. You can imagine that eyes with refracting surfaces shaped like footballs do not focus light very well!

If astigmatism is not corrected, even patients with clear lenses after cataract surgery will have blurred vision. Traditionally, astigmatism is corrected with eyeglasses or contact lenses. For those patients with cataracts and astigmatism who desire increased freedom from glasses, there are several surgical methods for correcting astigmatism:

• Placement of a Toric (Astigmatism Correcting) Intraocular Lens: this procedure involves the use of a more expensive type of implant (a toric IOL) that corrects for astigmatism. Rarely, toric implants can rotate out of position after surgery, requiring surgical repositioning.
• Limbal Relaxing Incisions (LRI): these are made at the time of cataract surgery with a diamond. As they heal, they flatten the steep part of the cornea and steepen the flat part of the cornea, thus making the cornea more round.
• Excimer laser refractive surgery (PRK and LASIK): PRK and LASIK are the most precise methods for reducing astigmatism. Since most cases of astigmatism with cataracts can be easily managed with LRI’s and toric IOL’s, excimer laser refractive surgery is rarely necessary after cataract surgery.

Prior to surgery for astigmatism, a number of special measurements are taken, and extra care is needed in the planning for and execution of surgery. Custom Astigmatic Surgery will be used to target either distance vision in both eyes or monovision, depending upon your goals. Because astigmatism can otherwise be easily corrected for with eyeglasses, surgical correction of astigmatism is considered by Medicare and private insurance carriers to be a cosmetic or luxury procedure and is not covered by insurance.