Implantation of Toric Intraocular Lenses:
Personalized Surgery on the Lens
Iva Dekaris, Nikica Gabric ́, Ante Barisˇic ́, and Alma Bisˇcˇevic ́
Abstract One of the most widely performed surgical procedures nowadays is
cataract surgery combined with monofocal intraocular lens implantation (IOL).
Monofocal IOLs are able to compensate for the spherical refractive error but not
astigmatism. Thus, patients with astigmatism are unable to see well after surgery
without spectacles. New generation of IOLs, called toric IOLs, improve
uncorrected visual acuity in eyes with high astigmatism due to a specific lens
design. The amount and the axis of astigmatism in each particular eye is specific;
thus, toric IOL has to be produced individually, making cataract surgery in patients
with astigmatism a personalized one. Additional problem with monofocal IOLs in
all cataract cases (including those with astigmatism) is presbyopia. With monofocal
lenses, only the distance vision is fully corrected and every patient has to wear
spectacles for near vision. Optical design of IOLs with more foci, so-called
multifocal IOLs, enables patients to see well both at a distance and near. When
first models of toric bifocal and trifocal IOLs were invented, combined refractive
errors (myopia, hyperopia, or presbyopia with astigmatism) could also be success-
fully corrected. Toric multifocal IOLs are again produced as personalized lens since
the amount and angle of astigmatism is different in each eye. A truly exciting new
era has started in the field of ophthalmology, enabling the surgeon to provide
patients with specific needs with an intraocular lens produced specifically for
them and thus to fully correct patient vision at all distances.
1 Introduction
Cataract, or opacification of the lens, is globally the most frequent cause for vision
loss. According to WHO data, it accounts for 48 % of world blindness. The main
cause for cataract is age, although it can also be a congenital disease or induced by
I. Dekaris, M.D., Ph.D. (*) • N. Gabric ́, M.D., Ph.D.
Specialty Eye Hospital‘Svjetlost’, Zagreb, Croatia
Department of Ophthalmology, University of Rijeka, Rijeka, Croatia
e-mail:[email protected]
A. Barisˇic ́, M.D. • A. Bisˇcˇevic ́, M.D.
Specialty Eye Hospital‘Svjetlost’, Zagreb, Croatia
©Springer International Publishing Switzerland 2016
N. Bodiroga-Vukobrat et al. (eds.),Personalized Medicine,Europeanization and
Globalization 2, DOI 10.1007/978-3-319-39349-0_11
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