Quality Eye Care, P.C.

Acrysof® Toric

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Routine cataract surgery with a traditional monofocal implant does not necessarily eliminate the need for glasses for distance, near, intermediate vision, or all three. In other words, patients usually need to use glasses after cataract surgery with a traditional implant (but with those glasses, the vision should be clearer and patients should have fewer symptoms than before). One of the factors that can limit the sharpness of uncorrected vision (without glasses) after cataract surgery, is astigmatism. What is astigmatism? Astigmatism is an uneven curvature of the cornea. Like nearsightedness or farsightedness, astigmatism can make the vision blurry. It's easier to understand this concept by first asking the question, what does it mean to not have astigmatism? In simplistic terms, if there is no astigmatism, the cornea of the eye (see Tour of the eye) is shaped like a baseball cut in half. The curvature or steepness of the resulting half-dome is the same regardless of the direction from which it is viewed (imagine a miniature version of you walking around the circumference of this half-dome). Compare this to a cornea which is similar to a football cut in half lengthwise (in the long direction, through both pointy ends). The curvature of the cornea in the long direction (along the seams) is not as steep as along the short direction. Such a cornea focuses light, not at a single point, but at 2 points. Someone who has uncorrected astigmatism may see images that are fuzzy and doubled.

For patients who do have a significant amount of corneal astigmatism, getting a a toric implant at the time of cataract surgery would, in most cases, allow for good distance vision without glasses, though "cheaters" would still be necessary for reading or intermediate viewing. If such a patient just received a traditional lens implant, glasses would likely be necessary for distance, reading, and intermediate vision, usually bifocals, trifocals, or progressives.

One type of toric implant is the Acrysof® Toric IOL. In FDA studies, 60% of patients who received an Acrysof® Toric IOL in one eye achieved spectacle freedom for distance vision, compared to less than 40% of patients who received a non-toric or traditional monofocal IOL in one eye. Of the patients who received the Acrysof® Toric in both eyes, 97% achieved spectacle freedom for distance vision, compared to only 50% of patients who received non-toric or traditional monofocal IOLs in both eyes. In short, the Acrysof® Toric implant can reduce the need for glasses after cataract surgery in patients with astigmatism.

Frequently Asked Questions about Acrysof® Toric implant

Will insurance pay for my Cataract surgery?
If you have a cataract which is visually significant, medical insurance typically covers the cost of surgery, though you may be responsible for a deductible, and there may be higher out-of-pocket costs if your primary insurance is Medicare and you do not have secondary insurance. You may speak to our billing specialist, Sharon, to find out about coverage. Remember, medical insurance is different than vision insurance which many people do not have. In general, vision insurance pays for glasses and contact lenses.

Medicare and other insurance companies pay for medically-necessary procedures. Routine cataract surgery with a monofocal-type or non-Acrysof® Toric implant is what they consider medically necessary. Medicare and most insurance companies realize that more testing and care is required for a patient who has opted for cataract surgery using the Acrysof® Toric implant, so they allow surgeons to charge more for cataract surgery with the use of this implant. However, they consider the Acrysof® Toric implant a deluxe or luxury item, and more than medically necessary, hence, they will only pay the surgeon fee up to what they pay for cataract surgery using the traditional monofocal implant. The additional surgeon fee for surgery using the Acrysof® Toric implant is the responsibility of the patient. Medicare and the insurance companies will only pay surgery centers (hospitals or ambulatory surgery centers) the cost of a monofocal implant; the difference in cost between a monofocal implant and the more expensive Acrysof® Toric implant is the responsibility of the patient. The end result is that a patient who opts to have cataract surgery using the Acrysof® Toric implant is responsible for paying an additional fee to both the surgeon and surgery center.

Financing is available for the additional costs associated with the Acrysof® Toric. Both traditional and no-interest loans are available. The application process is very simple, and if approved, can make the Acrysof® Toric implant an affordable dream come true!