Dr.Suhas Haldipurkar, Dr.RAVISH VAISHNAV, Dr.Vijay Shetty, Dr.AJINKYA KULKARNI, Dr.Nancy Sehdev
Toric IOL improves UCVA & provide glass-free distance vision. Patients with minimum 1.25D cyl are eligible for Toric IOL. Contraindications are -asymmetric astigmatism eg- Fuchs’ endo dystrophy, pseudoexfoliation, traumatic zonulolysis. Proper pre-op assessment is very important & includes- Manual-K, Auto-K, IOLM-K, LenStar, Topography, Oculyzer and Orbscan. Reference marking methods- Pre-op limbal marking of the horizontal axis of eye with patient sitting upright to correct for cyclotorsion. Done at the slitlamp with a coaxial thin slit 0-180 degrees. Free hand, Bubble-marker are few other techniques. 1º IOL rotation results in loss of 3.3% of IOL cylinder power. IOL material (Adhesion to posterior capsule by extracellular matrix proteins Tackiness, Central thickness) and IOL Design (Overall IOL diameter- The longer diameter IOL had better rotational stability). Newer technologies for accurate placement are available- Leica toric eyepiece, Callisto, SMI, Zaldiver caliper on i-Trace