Who might be poor candidates?
Pseudoexfoliation is the most common contraindication to a toric IOL, he continued.
Patients with zonular weakness are also poor candidates for a toric IOL because the lens is more likely to rotate after implantation. For patients with less than 1 D of astigmatism, astigmatic keratotomy—with or without a femtosecond laser—may be a viable alternative to a toric lens.
“Premium IOLs, especially toric IOLs, offer significant advantages for patients with glaucoma,” Dr. Lewis said. “But as with any lens, patient selection is key to achieving the best possible outcome.
“At the end of the day, our real job is to get patients the best possible vision we can,” he added. “For the vast majority of patients, a premium IOL is the most effective way to deliver on that promise.”