If this occurs, limbal relaxing incisions can complement the lenses. For patients in whom one lens rotates, he'll forego the toric lens in the second eye, opting instead for limbal relaxing incisions. To fix a rotated toric lens, Jackson, Mich., surgeon Paul Ernest goes back into the eye under sterile conditions after marking the astigmatic axis. I use a syringe on a 30-ga. As I nudge the lens with the nose of the cannula, I inject the b.s.s. to keep the chamber from collapsing.
Some surgeons like to use incisional techniques to treat astigmatism.
They'll do this either as a complement to the toric IOL or in place of it. A number of surgeons share his concerns. The haptics' big holes are supposed to allow the bag to seal through them to prevent this from happening. However, the risk still exists, even with the large holes. In addition, as with all pure incisional keratorefractive procedures, age is a factor.