Toric Lens Implant for 87 Year Old?

Question: My 87 year old father will be having his 2nd eye cataract removal soon. He had the first cataract done 5 years ago with another cataract surgeon. This time the surgeon recommended a toric lens. This cataract specialist's nurse told my dad he had an astigmatism and they would need to use the toric lens. My Dad agreed, but now is wondering at his age, if this toric lens is absolutely necessary. When he had the first cataract surgery, they didn't use a special lens. We are willing to go ahead with the procedure, but would like your input as to the necessity of the special toric lens. Thanks for your help!


Answer: There first thing you should know is that toric lens implants to correct astigmatism weren’t available as an option 5 years ago when your father’s first cataract was removed and this may be the reason a conventional monofocal lens implant was used. Or, it could have been possible that even if they were available, your father didn’t have astigmatism in the first eye. People who have preexisting astigmatism-astigmatism before cataract surgery-will need to have their astigmatism corrected by one of three methods in order to see as well as they should after cataract surgery. People with astigmatism can wear eyeglasses after cataract surgery, have a second surgery to correct astigmatism called Limbal Relaxing Incisions (LRI) or have an astigmatism correcting toric lens implant (IOL) as part of the cataract surgery. The astigmatism needs to be corrected by one of these methods so that your father can see his best.

As we get older, the need to see clearly remains quite important, not only for our daily activities but also for our mobility and safety. You and your father have to decide which of the three ways is best for your finances, lifestyle and safety. Being dependent on eyeglasses to get out of bed in the dark or dim illumination can be a big deal-one missed step, one stumble on a rug can be a disaster-thus unless there is some compelling reason otherwise, seeking “glasses free” correction through the LRI or toric lens is a better option at 87 years old. ALL three options have cost-some greater than others, and only you and your father can decide.

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