TORIC IOL’SDo we need them?

Frank goesfrank@goes.be

Escrs 2011

TORIC IOL’S

OR FEMTOLASIK AS A REDO TOOL OR INCISION MODULATION TRY TO

AVOID THE NEED OR A COMBINED APPROACH OF

BOTH PRINCIPLES

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SURGERYIOL CHOICE

IOL POWER CALCULATION

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OUR EXPERIENCE

MOSTLY LASER CORRECTION VISUMAX FEMTOLASIK SINCE 2 YEARSBUT

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-12 SF -4.5 cyl. AXIS 135 OD-11 SF -3.5 cyl.axis 75 OS

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HOW TO APPROACH CASE I

ARTIFLEX TORIC

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OPHTEC ARTIFLEX TORIC ENCLAVATION NEEDLE AND SPATULA

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ANIMATIE

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VERY HAPPY PATIENT

UNCORRECTED OD O.9 20/22OS O.9 20/22

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CANDIDATE MULTIFOCAL IOL ????????

CASE II

OD SF+6 cyl -5.5 axis 85°0S SF +5.5 cyl -6 axis 95°

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TECNIS MF OO

HIGHLY MOTIVATED TO BECOME SPECTACLE FREE

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1.TEMPORAL INCISION PLACEMENT

2.SECOND INCISION OPPOSITE SIDE

3.LARGER INCISION4.FOLLOWED BY LASIK 00

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A VERY HAPPY PATIENT

SPECTACLE FREE FOR DISTANCE AND FOR NEAR

VERY BUSY BUSINESSMANON THE PLANE AT LEAST ONCE A

WEEK

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CASE III

OD +6 CYL -6 AXIS 115OS +6 CYL -6 AXIS 95ACRILISA TORIC OD 20.5 +5.5 DOS 20.5 +6.5 D

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CARL ZEISS AT LISA toric 909M World first toric multifocal MICS IOL Flagship product for CZM absolutely unique AT LISA toric 909M combines the excellent optical performance of AT LISA and reliable astigmatsim correction of AT TORBI™ 709M in one iol Carl Zeiss calculates the power of AT LISA toric 909M for optimal surgery outcome

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PREOP

PREOP POSTOP OD UCVA 0.2 0.6 BCVA 0.9/sf.+5 cyl -6 axis 115 0.9/ -0.5 cyl.-1 axis 120

OS UCVA 0.2 0.7 BCVA 0.8/sf+6 cyl.-6 axis 95 0.9/ -1 axis 65

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Wanted Improvement !!!!!! FEMTOLASIK OO

ENDPOINT UCVA

OD 1.0OS 1.0

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OUR EXPERIENCE FEMTOLASIK AS A TOUCH UP AFTER PREVIOUS REFRACT

IVE LENS SURGERY

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REASON FOR TOUCH UP WITH LASIK

Patient dissatisfactionDiscuss beforehand to pay or not to payWhen Improvement possibleExclude all other pathology

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PRE POST LASIK UCVA47 EYES

0102030405060708090

PREPOST

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PRE POST LASIK BCVA47 EYES

8,1

8,2

8,3

8,4

8,5

8,6

8,7

PREPOST

LOSS GAIN OF LINES OF BCVA

LOSS OF MORE THAN ONE LINE:not one eye

GAIN OF MORE THAN ONE LINE: 4 eyes

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INDICATION

Refractive outcome different from plano.Sf.Eq.Myopia in 60%Sf.Eq.hyperopia in 40%Astigmatism > 1 dptr. in 64% of the eyes

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When Astigmatism was present it was

Against the rule in 70%

With the rule in 30%

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TORIC IOL’S

No doubt for important astigmatism

Minor deviations sometimes better predictability with

Femtolasik

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Thanks for the Attention

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