Tuesday, October 18, 2011

Toric Lens Implant Cost for Astigmatism

Question: I currently need cataract surgery and my doctor has recommended toric lens implants. My prescription is around -9.5 diopters with .75 diopters of astigmatism correction. His plan sounded fine until they told me it would cost $1300 extra (out of pocket) for the toric lens, etc.. When we were discussing multifocal lenses (and decided against them) he said he could make an LRI incision to relax the astigmatism for an extra $200. The one option he didn't offer was to implant a normal lens and use LRI to correct for astigmatism. Other than the cost, is one method better than the other, given that the amount of astigmatism is pretty small? Is there any increased risk using LRI? Longer recovery time? More pain? Less predictable results? I'd like to be able to see, but I'd like not to have to sell my car in order to pay the extra (possibly unnecessary) cost.

Answer: Patients with Cataracts in need of Cataract Surgery who have preexisting astigmatism.are able to opt for three different methods of correcting that astigmatism after the Cataract has been removed. First, they can simply buy eyeglasses and use them to get the best possible vision. Second, they can have Limbal Relaxing Incisions (LRI) a secondary surgical procedure or third they can have an astigmatism correcting Toric Lens Implant. You do not state whether .75 diopters is your spectacle correction for astigmatism or the predicted postoperative astigmatism to be corrected.

These two values MAY be different as depending on the orientation of the astigmatism and the position of the incision it is possible that during the healing process some Cataract Surgeons find an increase in the amount of astigmatism. Let's assume that the actual amount to be corrected in .75. LRI is as the name suggests an incisional surgical procedure and is dependent on wound healing to produce its effects. ANY time we depend on wound healing there is patient to patient variability and less predictability. Further, some patients require repeated LRIs as the effect tends to neutralize-sometimes never quite producing the exact desired effect. yes, each repeated procedure is another slight set of surgical risks.

Last, with LRI there is a the question of permanence and whether the quality of the optical correction is equivalent to the optics of an intraocular lens implant (IOL) in terms of aberrations and distortions.Yet, with a skilled Cataract Surgeon the results of LRI can be quite good for many patients. Astigmatism correcting Toric Lens Implants can offer greater precision of the correction upon careful measurement, analysis, surgical planning and surgical procedure-and they are manufactured with controlled aspheric optics to minimize aberrations. So, from PURE OPTICAL STANDPOINT, astigmatism correcting toric lens implants are generally preferred. Shortly, astigmatism correcting multifocal lens implants will become the correction of choice for most patients upon their FDA approval and marketing availability. Really the choice of how to correct the astigmatism is entirely yours. It sounds as if your Cataract Surgeon is presenting you with what in his or her opinion is the best clinical options and trying not to let the short term cost of the Toric Lens Implant influence the best clinical choice over the longer term

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

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