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Subspecialties Cataract, Glaucoma

The Case for Premium

Premium lenses – which I define as toric lenses and multifocal or extended depth of focus (EDOF) lenses – are sophisticated devices; but are they right for glaucoma patients? The brief answer is that ideal outcomes require careful matching of IOL options with patient characteristics and expectations – and appropriate use of the range of MIGS procedures.

Toric lenses are designed to correct astigmatism – and glaucoma patients at almost any stage of disease can be good toric IOL candidates. As long as patients have good central vision, correcting astigmatism will improve quality of vision and life; therefore, any astigmatic glaucoma patient who wants good distance vision should be offered the toric IOL option. That said, the best candidates are those with 1D astigmatism or above; patients with lower levels of astigmatism may be better served by femtosecond laser limbal relaxing incisions. But do remember that toric procedures can be disappointing in glaucoma patients with central vision loss; the macula must be very healthy to be sure of a good outcome with a premium IOL.

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About the Author

Constance Okeke

MD, MSCE and glaucoma and cataract surgery specialist

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