When it comes to cataract surgery or vision correction, toric lenses often come up as a solution for people with astigmatism. If you’re considering toric lenses or have been told they might be right for you, you’re bound to have a few questions. So, let’s dive right in and address the 15 most common questions people ask about toric lenses—with clear, honest, and straightforward answers to help you feel more confident in your choices.
1. What are toric lenses?
Toric lenses are specially designed intraocular lenses (IOLs) that correct astigmatism as well as short-sightedness or long-sightedness. Unlike regular lenses, which have a uniform curvature, toric lenses have varying powers in different meridians of the lens. This unique shape allows them to bend light more precisely onto the retina, offering clearer, sharper vision for people who have an irregularly shaped cornea.
If you have astigmatism, your cornea isn’t perfectly round—it’s more like a rugby ball than a football. A standard lens wouldn’t be able to correct this irregularity, leaving you still needing glasses after cataract surgery. Toric lenses are specifically made to counteract this distortion, meaning many patients can dramatically reduce or even eliminate their need for glasses after surgery.
It’s important to note that toric lenses must be carefully aligned during surgery. A slight rotation can affect their performance, so precision placement is key. Your surgeon will measure your eye’s axis beforehand and adjust the lens carefully during the procedure to ensure the best possible results.
2. Who is a good candidate for toric lenses?
Toric lenses are primarily intended for people who have both cataracts and significant astigmatism. If you have been struggling with blurry or distorted vision even before cataract development, and you’ve been told you have astigmatism, there’s a good chance you could benefit from a toric lens during cataract surgery.
However, suitability also depends on the overall health of your eye. If you have other eye conditions like macular degeneration, severe glaucoma, or diabetic retinopathy, toric lenses may not be the best option for you. These other issues might limit the amount of vision improvement you can achieve, regardless of how well your astigmatism is corrected.
A thorough examination by your ophthalmologist will determine if toric lenses are right for you. They’ll assess your eye’s surface, overall health, and lifestyle needs before making a recommendation tailored to your circumstances. Don’t be afraid to ask about alternatives too, just to ensure you’re making an informed decision.
3. How do toric lenses correct astigmatism?
Toric lenses have different powers in specific parts of the lens, allowing them to correct the uneven curve of an astigmatic eye. They focus light more precisely onto the retina, compensating for the cornea’s irregular shape. The lens acts much like a prescription pair of glasses that corrects astigmatism—but it’s placed inside your eye permanently after cataract removal.
During cataract surgery, your surgeon will insert the toric lens at a specific angle based on the orientation of your astigmatism. Even a few degrees off can reduce the lens’s effectiveness, so surgeons use sophisticated tools and techniques to ensure perfect placement. In some cases, the lens may be rotated slightly during the procedure to achieve optimal alignment.
After healing, the lens remains stable inside your eye, providing ongoing correction without the need for glasses or contact lenses in most cases. It’s a remarkable advancement that has helped countless people achieve better vision and greater independence from spectacles.
4. Are toric lenses more expensive than standard lenses?
Yes, toric lenses do tend to be more expensive than standard monofocal lenses. This is primarily because they are designed to correct astigmatism in addition to cataracts, offering a more customised and complex solution. The manufacturing process for toric lenses is more sophisticated, and fitting them correctly during surgery requires additional skill and time.
In many countries, including the UK, the NHS offers basic cataract surgery with a standard monofocal lens at no extra cost. However, if you choose a toric lens, this is usually considered a premium option, and you may need to pay privately or through an upgraded package at a private clinic.
When weighing the cost, it’s worth considering the long-term benefits. Toric lenses can dramatically reduce your dependence on glasses, potentially saving you the ongoing cost and inconvenience of eyewear upgrades and prescriptions over time. For many patients, the investment in a toric lens is well worth it.
5. Is the surgery for toric lenses different from standard cataract surgery?
The overall procedure for inserting a toric lens is very similar to standard cataract surgery. The surgeon still removes your cloudy natural lens and replaces it with an artificial one. However, there is one crucial difference—the need for precise alignment of the toric lens.
Before your surgery, additional measurements will be taken to map the exact orientation of your astigmatism. During the operation, your surgeon will use special markings on your eye or advanced imaging technology to ensure the lens is positioned at the correct axis. This attention to detail helps maximise the effectiveness of the astigmatism correction.
Recovery after surgery is typically the same as it would be for a standard lens. However, it’s even more important to avoid rubbing your eye or putting pressure on it during the healing period, as movement of the lens in the early days can compromise the outcome.
6. Can toric lenses rotate after surgery?
Although rare, toric lenses can rotate slightly after surgery, particularly within the first few weeks of healing. This rotation can reduce the effectiveness of the astigmatism correction and may result in blurred or distorted vision.
If rotation happens, your surgeon might recommend a minor secondary procedure to reposition the lens. It’s usually a quick and straightforward adjustment, done under local anaesthetic, and most patients recover well afterwards.
To minimise the risk of rotation, it’s important to follow your post-operative care instructions carefully. Avoid rubbing your eyes, heavy lifting, or straining, especially in the early weeks after your surgery. Keeping your eye protected gives the lens the best chance to settle securely into place.
7. What if the toric lens doesn’t fully correct my astigmatism?
In some cases, a small amount of astigmatism may remain even after toric lens implantation. This is sometimes referred to as residual astigmatism. It can occur due to slight healing differences, minor misalignments, or changes in the shape of the eye after surgery.
If the residual astigmatism is minor, you may not even notice it, or it might only require a low prescription for tasks like reading or night driving. Many patients are happy with the results and do not need further intervention.
If the residual astigmatism is more noticeable and bothersome, there are solutions available. Glasses or contact lenses can fine-tune the correction, or your surgeon might recommend a minor surgical enhancement, such as laser vision correction, to refine the outcome even further.
8. Can toric lenses correct presbyopia too?
Toric lenses are primarily designed to correct astigmatism along with either distance or near vision, but traditional toric lenses do not correct presbyopia (the age-related loss of near vision). If you also want to reduce your dependence on reading glasses, you would need to consider a different type of lens, such as a multifocal toric lens or an extended depth of focus (EDOF) toric lens.
Multifocal toric lenses combine astigmatism correction with the ability to focus at multiple distances. They are a more complex technology and may involve a greater period of adaptation as your brain learns to switch between different focal points. Some patients love the freedom these lenses provide, while others may notice issues like glare or halos around lights, particularly at night.
It’s important to discuss your lifestyle needs and visual priorities with your surgeon before deciding. For example, if you do a lot of night driving or need very crisp vision at one particular distance, a standard toric monofocal lens might still be the better choice, even if it means using reading glasses occasionally.
9. Are toric lenses safe?
Yes, toric lenses are very safe when implanted by an experienced surgeon. They have been used successfully in millions of cataract surgeries worldwide and have a strong track record of improving vision and reducing astigmatism. Like all surgical procedures, there are small risks, but serious complications are rare.
The most common risks are similar to standard cataract surgery—such as infection, inflammation, or retinal detachment—but these risks are very low when appropriate precautions are taken. The main toric-specific risk is lens rotation, which, as mentioned earlier, can usually be corrected if it happens.
Choosing a reputable clinic and an experienced surgeon is the best way to ensure a safe and smooth experience. Always ask about your surgeon’s experience with toric lenses and their approach to managing any potential complications.
10. Will I still need glasses after getting toric lenses?
Many patients who receive toric lenses find that their need for glasses is greatly reduced, especially for distance vision. If your surgery goes well and your astigmatism is fully corrected, you might not need glasses for everyday activities like driving, watching television, or going out.
However, you may still need reading glasses for close-up tasks like reading, sewing, or working on a computer, particularly if you’ve chosen a monofocal toric lens focused on distance. If complete freedom from glasses is your goal, you might want to explore multifocal toric lenses or consider additional procedures to address near vision.
It’s always good to set realistic expectations. While toric lenses offer a significant improvement, they don’t guarantee total spectacle independence unless carefully combined with other vision correction strategies tailored to your needs.
11. How long do toric lenses last?
Toric lenses are designed to last a lifetime. Once implanted, they remain in your eye permanently and do not wear out, break down, or need replacement under normal circumstances. The material used in modern lenses is biocompatible and built to remain clear and stable for decades.
Unlike glasses or contact lenses, which need regular replacement, your toric intraocular lens becomes a part of your eye. After surgery, you can expect it to stay securely in place without any maintenance, provided there are no unusual complications.
Occasionally, some patients may experience clouding of the membrane behind the lens months or years after surgery—a condition called posterior capsule opacification (PCO). This isn’t a lens problem and can be easily treated with a quick, painless laser procedure called YAG laser capsulotomy to restore clear vision.
12. What happens if my toric lens needs repositioning?
If your toric lens rotates significantly after surgery, and you notice your vision is blurry or distorted, your surgeon might recommend a repositioning procedure. This typically involves a short, low-risk surgery to adjust the lens back into the correct orientation.
The repositioning procedure is generally straightforward and quicker than the original cataract surgery. It’s often performed under local anaesthetic as a day case, meaning you’ll go home the same day. Most patients recover quickly and notice an improvement in their vision soon after.
It’s reassuring to know that needing a repositioning is relatively rare, and surgeons take great care during the initial operation to minimise this risk. Still, it’s good to be aware that correction is possible if it becomes necessary, so you don’t need to worry if the unexpected happens.
13. How is the right toric lens power selected for me?
Selecting the correct toric lens power involves a detailed pre-operative assessment. Your surgeon will use advanced imaging technology, like corneal topography and biometry, to precisely measure the shape, thickness, and curvature of your eye, as well as the amount and axis of your astigmatism.
These measurements are then used to calculate the best lens strength and orientation for your particular eye. Some clinics also use digital mapping systems to create a 3D model of your eye, ensuring even greater precision in planning your surgery.
Getting these measurements right is crucial for achieving the best visual outcome. If you’re going to invest in a premium lens like a toric one, it’s well worth choosing a clinic that offers the latest diagnostic tools and has extensive experience in toric lens implantation.
14. Is there a recovery period after getting toric lenses?
Yes, recovery after toric lens surgery follows a similar pattern to standard cataract surgery. Most people notice a significant improvement in vision within a few days, but full healing can take several weeks. During this time, your vision may fluctuate slightly as your eye adjusts and any mild swelling settles.
You’ll need to use prescribed eye drops to prevent infection and inflammation, and you should avoid strenuous activity, heavy lifting, and rubbing your eyes during the initial healing phase. Wearing a protective shield at night for the first week or two is often recommended.
Follow-up appointments are crucial to monitor your healing and ensure that the lens remains properly aligned. Your surgeon will check your vision and the lens position during these visits and advise if any further treatment is necessary to optimise your visual outcome.
15. What should I ask my surgeon before deciding on toric lenses?
Before committing to toric lenses, it’s smart to have an open conversation with your surgeon. Ask about their experience with toric lens implantation and their success rates. It’s also wise to discuss the likelihood of residual astigmatism and whether enhancements might be needed later.
You should also ask about the types of toric lenses available—whether standard monofocal toric lenses or multifocal toric options—and which one best suits your lifestyle. Discuss the costs involved, especially if you’re having surgery privately, and clarify what’s included in the package (like repositioning procedures if needed).
Finally, make sure you understand the recovery process, the expected results, and any possible risks. Feeling fully informed will help you go into surgery with confidence and realistic expectations about what toric lenses can achieve for you.
Final Thoughts
Choosing toric lenses can be a life-changing decision if you have astigmatism and are planning cataract surgery. They offer the opportunity for clearer, sharper vision and greater freedom from glasses. As with any medical decision, understanding the pros, cons, and process is key. Hopefully, this guide has helped you feel more prepared to discuss your options with your ophthalmologist and take the next steps towards clearer sight!
If you’d like to learn more about private cataract surgery and the best lens options for your needs, feel free to get in touch with us at the London Cataract Centre — our team would be happy to help.