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Toric multifocal lenses correct astigmatism & extend vision - A State of Sight #132

We are very happy to have toric multifocal lens implants available for our patients who are having cataract surgery. These lenses can correct astigmatism and give the widest range of vision possible without glasses and contact lenses after surgery.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about this advanced technology. Two of the most common toric multifocal lenses are the Tecnis Symfony toric lens, and the Restor toric lens.


Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain toric multifocal lens implants that can be placed at the time of cataract surgery for our patients who have astigmatism and would like a full range of vision from up close to far away without using glasses (as much as possible).


We are very happy that these implants are now available. A few years ago, the only option was the standard multifocal lens. This multifocal lens did not correct for astigmatism, so we would have to correct astigmatism at the time of cataract surgery with separate incisions as below.


For our patients who have bladeless cataract surgery using the LenSx femtosecond laser, we can use the laser to create extra incisions in the cornea to help lower their astigmatism (arcuate keratotomies or AKs).


For patients who choose basic cataract surgery, we can create these extra incisions manually, which are called limbal relaxing incisions (LRIs). LRIs are placed towards the edge of the cornea in the area where the astigmatism is located. Both of these types of incisions are not as accurate in treating astigmatism as a toric lens implant, but generally they can help lower the amount of astigmatism.


Now, since we have toric multifocal lenses, they are the most accurate way to treat astigmatism at the time of cataract surgery. This lens implant is aligned inside the eye in the direction of the patient’s astigmatism. The lenses come in different powers, so depending on the amount of astigmatism, we can pick a stronger or weaker toric lens implant. Then, after cataract surgery, the best uncorrected vision is possible because multifocal lenses function best when astigmatism is corrected as well.


If there is still some astigmatism remaining after surgery and the vision is not as clear as it should be, we must first ensure that the lens in the correct position that we placed it at the time of surgery. Rarely, these lenses can move or rotate and it may take a second procedure to reposition the lens to the correct location.


Otherwise, if the lens is aligned properly and there is still remaining astigmatism, our patients may need to have a laser procedure (LASIK or PRK) to correct the rest of the astigmatism to obtain their best vision.


The brand names of the most commonly used toric multifocal lenses are the Tecnis Symfony toric lens and the Restor toric lens. If you have any questions about these lenses, please post and we will be happy to answer them.


If you are interested in obtaining a toric multifocal lens at the time of cataract surgery, ask your eye doctor to refer you to Porter Ophthalmology and we will be happy to discuss your options. We hope to see you again soon next time on A State of Sight.