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DR Brad Townend: Gosford and Wyong Eye Surgery
DR Brad Townend: Gosford and Wyong Eye Surgery
and
CATARACT
SURGERY
Dr Brad Townend
BSc(Med), MBBS, MPH, MMed,
FRANZCO
Toric IOL
Correction of corneal
astigmatism
Conoid of Sturm
TORIC
LIMITATIONS
Neutralise corneal astigmatism in the
plane of the Effective Lens Position (ELP)
Higher order aberrations (Hayashi et al, JCRS 2012)
Time consuming
Reliability of outcomes
THRESHOLD FOR
USE
1.5 Dioptres of corneal astigmatism
Improving Toric
Outcomes
Counsel patients
appropriately
Plate haptic lenses offer
better capsule stability and
less rotation post-operatively
Improving Toric
Outcomes
Use a formula that utilises ACD
E.g. Haigis or Holladay2
Improving Toric
Outcomes
Manage paralax error
ASICO electronic toric marker
Built-in protractor
Improving Toric
Outcomes
Surgically Induced Astigmatism (SIA)
Mark wound location with toric marker
Use consistent keratome size
Concentrate on making a consistent antpost position of your wound
Perform a good surgical audit to
calculate your SIA
Key contributor to toric outcome (W Hill,
JCRS, 2008)
Improving Toric
Outcomes
Toric lenses are being used more
frequently
Potential to improve patient
outcomes significantly
Understand their limitations and use
initiative to minimise these