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Experts debate use of toric, premium IOLs in eyes with abnormal corneas
SAN FRANCISCO — Two speakers here debated the efficacy of toric and premium IOLs in patients with abnormal corneal topography.
Charles D. Reilly, MD, and Michael W. Belin, MD, spoke during Cornea Day preceding the American Society of Cataract and Refractive Surgery meeting.
Successful toric IOL implantation in patients with corneal abnormalities hinges on reasonable agreement in the magnitude and axis of cylinder between topography and refraction. In addition, patients should have realistic expectations regarding outcomes, Reilly said.
"The patient also has to have reasonable visual potential," he said. "You want to be aware of meridional amblyopia in these patients. Consider status of the other eye and also be aware of the posterior corneal contributions to cylinder."
Intraoperative wavefront aberrometry may help ensure the accuracy of lens placement, Reilly said.
"A good tailor recognizes that ‘one size fits all’ doesn’t apply, and a good surgeon needs to recognize the same," Belin said.
A spherical monofocal IOL may be preferable in patients with iris or pupil abnormalities or corneal distortion requiring a rigid gas-permeable contact lens; a spherical IOL can make contact lens fitting easier, Belin said.
Disclosures: Belin is a consultant for Oculus. Reilly is a consultant for Alcon.