EyeWorld Asia-Pacific December 2018 Issue

important point here,” he noted, adding that patients are happy to be able to get out of their glasses. “Overall, the data is positive. Most patients do benefit from toric lenses, and rotations are rare in normal individuals with no other past ocular history,” he said. Practical strategies There are some practical strate- gies that practitioners can use to minimize the risk of lens rotation. Rather than polishing the capsule, practitioners could leave some residual cells on the anterior lens capsule, which helps to provide a bit more “friction” to stabilize the IOL, Dr. Xue explained. Or practi- tioners may try slightly under-ro- tating the lens just before removing the OVD at the end. “When you remove the OVD, the lens tends to wobble slightly and rotate clock- wise,” he said. Dr. Xue hopes practitioners come away from the study with the realization that 80% of patients benefit from toric lens implanta- tion with visual acuity improve- ment in their treated eye, which is comparable to that attained with standard cataract surgery. “The other take-home message is that the lens rotation risk is there, particularly if the patient has had a previous vitrectomy,” he said. Dr. Xue continues to implant toric lenses in his unit. “We’re happy that we have that option available for our patients,” he said. “Cataract surgery with toric lens implanta- tion helps to achieve spectacle-free vision, which improves patient sat- isfaction, and is relatively straight- forward to perform. We hope to continue to offer this and work on ways to pick out patients who are at high risk of lens rotation in order to counsel them appropriately and modify our surgical technique to minimize the risks.” EWAP Reference 1. Xue K, et al. Real-world refrac- tive outcomes of toric intraocular lens implantation in a United Kingdom National Health Service setting. BMC Ophthalmol. 2018;18:30. Editors’ note: Dr. Xue has no finan- cial interests related to his comments. Contact information Xue: enquiries@eye.ox.ac.uk Real-world spin – from page 55 56 EWAP CATARACT/IOL December 2018