TORIC IOL’S
Do we need them?
Frank goes
frank@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
Escrs 2011
SURGERY
IOL CHOICE
IOL POWER
CALCULATION
Escrs 2011
OUR EXPERIENCE

MOSTLY LASER CORRECTION
 VISUMAX FEMTOLASIK SINCE 2 YEARS
 BUT
Escrs 2011
HOW TO APPROACH CASE I
-12 SF -4.5 cyl. AXIS 135 OD
-11 SF -3.5 cyl.axis 75 OS
Escrs 2011
ARTIFLEX TORIC
Escrs 2011
OPHTEC ARTIFLEX TORIC ENCLAVATION
NEEDLE AND SPATULA
Escrs 2011

ANIMATIE
Escrs 2011
VERY HAPPY PATIENT

UNCORRECTED
 OD O.9 20/22
 OS O.9 20/22
Escrs 2011
CANDIDATE MULTIFOCAL
IOL ????????
CASE II
OD SF+6 cyl -5.5 axis 85°
0S SF +5.5 cyl -6 axis 95°
Escrs 2011
TECNIS MF OO

HIGHLY MOTIVATED TO BECOME
SPECTACLE FREE
Escrs 2011
1.TEMPORAL INCISION
PLACEMENT
2.SECOND INCISION
OPPOSITE SIDE
3.LARGER INCISION
4.FOLLOWED BY LASIK 00
Escrs 2011
A VERY HAPPY PATIENT

SPECTACLE FREE FOR DISTANCE
AND FOR NEAR
 VERY BUSY BUSINESSMAN
 ON THE PLANE AT LEAST ONCE A
WEEK
Escrs 2011
CASE III

OD +6 CYL -6 AXIS 115
 OS +6 CYL -6 AXIS 95
 ACRILISA TORIC
 OD 20.5 +5.5 D
 OS 20.5 +6.5 D
Escrs 2011
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
Escrs 2011
PREOP

PREOP

OD
POSTOP

UCVA 0.2
 BCVA 0.9/sf.+5 cyl -6 axis 115
0.6
0.9/ -0.5 cyl.-1 axis 120


OS

UCVA 0.2
 BCVA 0.8/sf+6 cyl.-6 axis 95
0.7
0.9/ -1 axis 65
Escrs 2011
Wanted Improvement !!!!!!
FEMTOLASIK OO

ENDPOINT UCVA

OD 1.0
 OS 1.0
Escrs 2011
OUR EXPERIENCE
FEMTOLASIK AS A TOUCH UP
AFTER PREVIOUS REFRACT
IVE LENS SURGERY
Escrs 2011
REASON FOR TOUCH UP
WITH LASIK

Patient dissatisfaction
 Discuss beforehand to pay or not to pay
 When Improvement possible
 Exclude all other pathology

Escrs 2011
PRE POST LASIK UCVA
47 EYES
90
80
70
60
PRE
POST
50
40
30
20
10
0
Escrs 2011
PRE POST LASIK BCVA
47 EYES
8,7
8,6
8,5
PRE
POST
8,4
8,3
8,2
8,1
Escrs 2011
LOSS GAIN OF LINES OF
BCVA

LOSS OF MORE THAN ONE LINE:not one
eye
 GAIN OF MORE THAN ONE LINE: 4 eyes
Escrs 2011
INDICATION

Refractive outcome different from plano.
 Sf.Eq.Myopia in 60%
 Sf.Eq.hyperopia in 40%
 Astigmatism > 1 dptr. in 64% of the eyes
Escrs 2011
When Astigmatism was
present it was
Against the rule in 70%
With the rule in 30%
Escrs 2011
TORIC IOL’S
No doubt for important
astigmatism
Minor deviations sometimes
better predictability with
Femtolasik
Escrs 2011
Thanks for the Attention
Escrs 2011