TargetTalk

Trying to get as much info as possible before making decisions about cataract surgery. I have already made up my mind to have the surgery, but am getting different opinions concerning the lens to be used. I have a slight diagnosed astigmatism and the surgeon is recommending a toric lens for correction. From what I have read and talking to my optometrist I am not convinced that I need to spend the extra money for little or no appreciable gain. Anyone have any experience or suggestions, I would certainly appreciate it.
Thanks,
Rod

I have had an appreciable amount of astigmatism all my life (1.5 - 2D) so prior to my surgery did some reading on intraocular implants. The toric and the multifocus types were favorites. Just prior to DDay (well maybe SDay), I asked the surgeon about the toric implants. He replied that he had just reoperated on two patients due to implant rotation and he did not feel that torics were stable. He did say that some cylindrical correction could be achieved by positioning (both rotational as well as radial) of the two slits cut made to remove the old and insert the new lens.
In went the spherical implants and my vision went from 40/20 (R/H),200/20 (L/H) to 30-20/20in both eyes and down to about .7D cylndrical.
I can drive without glasses but do wear corrected lenses for shooting. Even after YAG laser surgery I do have some glare which does detract contrast slightly black front sight to white bullseye gap (subsix hold).
Do your homework (look at http://www.pubmedcentral.nih.gov/articl ... id=2408563) as well as other websites and talk to your surgeon. Its been a year since my surgery and things, I'm sure, have progressed since.
Good luck














http://www.pubmedcentral.nih.gov/articl ... id=2408563

I am having this conversation with my optometrist, too. He indicates that the toric and multifocus may not quite as sharp as the single focus. For many they are fine, but if you want or need the best sharpness, then go for those has been his advice. He also says that the techniques and materials are improving, so that he might not have the same opinion in two or three years.

As well, Dr. Norman Wong frequents the Bullseye-l list (http://www.lava.net/~perrone/bullseye/) and is an optometrist and competitor. He might have a few qualified comments to make on the subject.

That is the best source of information for cataract surgery that I have found and I wanted to thank you. I still haven't found any evidence that an astigmatism of less than 1.0 would receive that much benefit from the toric lens, plus I was curious if you had the LTI preformed to deal with your astigmatism. I am researching the "Aspheric" lens which is supposed to provide the best distance vision. Thanks again.
Rod

I am an optometrist and normally don't recommend the toric implant. If your astigmatism is low I don't think you would notice that much improvement and if it's high the potential for error could very likely negate any possible benefit. I have approximately 3 and 1/2 diopters astigmatism myself and if I were to have cataract surgery tomorrow I would opt to have a standard implant and simply make up the difference with my spectacle lens. Just my two cents. Best regards.

thanks for responding, I appreciate your advice
Rod

I had catarac surgery several years ago and had astigmatism prior. The surgeon used the position of slits on implant to correct that. I am 76 yrs old and can drive w/o glassses. Still need correction to read but thats all. What has screwed me up was the macular hole in my retina of 2007. That repair gave me 20/25+ in my right eye but it has lost the definition needed for target apertures. Guess I should be satisfied that I can still shoot with scopes at 76, huh?