By David L. McGarey, MD
Cataract surgery involves removing the eye’s cloudy natural lens and replacing it with a clear artificial lens called an intraocular lens (IOL). Today, three main types of IOLs are used in cataract surgery: monofocal, multifocal, and toric lenses.
The most common type, the monofocal IOL, has been used for decades. It provides a clear vision at a fixed distance—usually far—but does not correct astigmatism or allow distance and reading vision without glasses. Multifocal IOLs offer the convenience of clearer distance and near vision, reducing or eliminating the need for glasses, but they also do not correct astigmatism on their own.
This brings us to toric IOLs, which are specifically designed to correct astigmatism—a common condition where the cornea is shaped more like a football than a basketball. This uneven curvature prevents light from focusing correctly on the retina, causing blurred or distorted vision at all distances. In the past, correcting astigmatism required an additional procedure, such as LASIK, after cataract surgery.
Your surgeon may also consider whether basic or laser-assisted cataract surgery fits your treatment plan, since laser-created corneal incisions may help manage certain amounts of astigmatism in selected patients.”
Fortunately, the FDA has approved toric lenses for implantation during cataract surgery. These lenses feature built-in astigmatism correction, allowing surgeons to address nearsightedness, farsightedness, and astigmatism in a single procedure.
When it comes to correcting astigmatism:
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Glasses help.
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Contact lenses do a better job.
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But toric IOLs offer the most precise and lasting correction, right at the source.
What’s the trade-off? Toric lenses provide excellent distance vision but are not multifocal, meaning patients will still need reading glasses for up-close tasks. That said, many patients find the freedom from distance glasses and the improvement in overall clarity worthwhile.
Is a Toric IOL right for you?
You may be a good candidate if:
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You need cataract surgery,
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You have significant astigmatism, and
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You’re comfortable using reading glasses for near tasks.
Talk with your eye surgeon to determine if a toric IOL aligns with your vision goals and lifestyle.