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*=$6 1 :76 >567/9+ > +6 '7:*=$6 1 :76 >567/9+ > +6 '7:
# . > 796 *6$+5 +=# . > 796 *6$+5 +=6 & /91 ' $6?$6 & /91 ' $6?$
' . ' (' . ' (
6 '96=1 *$>/=6 '96=1 *$>/=' 3 5 $ ?7 7 * . .' 3 5 $ ?7 7 * . .>5=6 76 '= ?=>5 = 7 1 3 ('>5=6 76 '= ?=>5 = 7 1 3 ('
'9& = >15 595= $1 $1=6 =>56='9& = >15 595= $1 $1=6 =>56=# # . '## # . '#
* 7>=* 7>==,1 5= 192 = = +7?=,1 5= 192 = = +7??$?$ 192 = = ?$ +7?192 = = ?$ +7?
& 1 5 > 11 15$>5 *67:=1176 7 > 76$> = =>5=6& 1 5 > 11 15$>5 *67:=1176 7 > 76$> = =>5=6
(> 2=61 5 7: (5$ '$ 5 $ = 5 (5$ ('(> 2=61 5 7: (5$ '$ 5 $ = 5 (5$ ('' />= = 713 5$ (> 2=61 5 7: ' />= 9156$ $' />= = 713 5$ (> 2=61 5 7: ' />= 9156$ $
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=$6 1 :76 >567/9+ > +6 '7: =$6 1 :76 >567/9+ > +6 '7: # . > 796 *6$+5 +=# . > 796 *6$+5 +=
. ' # .. ' # ..# $5 .$ 396.# $5 .$ 396
$5 1 $6$5 1 $6 >/ $>/ $
75= $, 7>75= $, 7>.$ 396 >/ $.$ 396 >/ $
9 9159 915
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6 '96=1 *$>/= 36=1=>5 > 5$ 7> *=$6 1:76 >567/9+ > #76 + .# .$ 396
$5 1 $6 >/ $ 9
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6 '96=1 *$>/= 36=1=>5 > 5$ 7> *=$6 1:76 >567/9+ > #76 + .# .$ 396
$5 1 $6 >/ $ 9
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=/ +$5=/ 57 $5==/ +$5=/ 57 $5=*67:=1176 $2 / 33 =*67:=1176 $2 / 33 =
$ 76 / 6=>7 >=/$ 76 / 6=>7 >=/
73 5 $ ?7 7 15 =>576 $>/73 5 $ ?7 7 15 =>576 $>/.=1=$6+ =6 .=1=$6+ =6
*$11=/ $ $ 7>*$11=/ $ $ 7>9 915 $59 915 $5$ = 7: =$61$ = 7: =$61
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15 ?$5 1? 766=+5 7> /96 > +$5$6 15 ?$5 1? 766=+5 7> /96 > +$5$6
1 $1 $=/ +$ =+=11 5 =/ +$ =+=11 5 1 $ 196 =7> 7357?=56 15 +79>1= 76 1 $ 196 =7> 7357?=56 15 +79>1= 76
796 6=137>1 , 5 57 =/9+$5=796 6=137>1 , 5 57 =/9+$5= 3$5 =>51 $,795 5 1 3$5 =>51 $,795 5 1
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M h
h h
h h M
8/4/2019 Pearls for Introducing AcrySof Toric IOL in Practice Dr Suresh K Pandey, SuVi Eye Institute Kota, India
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M h h h
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* # # . # # . #(.* # # . # # . #(.
5 '9& = >15 75$ >/ $ 5 '9& = >15 75$ >/ $
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* # # . # # . #(.* # # . # # . #(.$5 '9& = >15 75$ >/ $$5 '9& = >15 75$ >/ $
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79>1= >79>1= >V $ = $ 1?$ + $> = > 796
6795 >= 36$+5 += , 1+6==> >
5 = 3$5 =>5 :76 =6$57?=56 :$>/ 5 => +79>1= 3$5 =>5 :76+$5$6$+5 196 =6
V *$5 =>51 $2 > P $6=+$>/ /$5= :76 576 +
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957957 =6$57?=56=6$57?=56 :76 '+6==> >:76 '+6==> >
+$1=1 :76 #76 + & /=7+$1=1 :76 #76 + & /=7
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79>1= >79>1= >V ?3 $1 = 5 $5 $:5=6 6=?72$ 7: +$5$6$+
196 =6 5 = >==/ 13=+5$+ = :76/ 15$>+=
V /9+$5= 3$5 =>5 5 $5 5 = 5=+ >7 7 1$2$ $, = :76 $15 ?$5 1? +766=+5 7>V 2= 735 7> 7: 576 + 57 796 3$5 =
$2 > $15 ?$5 1?V =2= 7: 13=+5$+ = :6==/7? :76
/ 15$>+= => ?3 $>5=/ $5=6$
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6 5 +$ '9++=116 5 +$ '9++=11$+576 1$+576 1
V =>56 $5 7>V *$5 =>5 1= =+5 7>V *6 = 3=6 $5 2=
?=$19 6 =?=>51V $ +9 $5 7>1 +6 '7: +6 '7: # .# .
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=>56$5 7>=>56$5 7>7 6 =2=6 /= 6 == 7:7 6 =2=6 /= 6 == 7:
6 75$5 7> 7: 5 =6 75$5 7> 7: 5 ==>1 37 =6 1 715=>1 37 =6 1 715
^ 7: 6 75$5 7> +79 /7: 6 75$5 7> +79 /+$91= +7?3 =5= 711 7:+$91= +7?3 =5= 711 7:
+ >/=6 37 =6 + >/=6 37 =6
+=11 2=6 75$5 7> +$>+=11 2=6 75$5 7> +$>$+59$ >/9+=$+59$ >/9+=
$// 5 7>$ $15 ?$5 1?$// 5 7>$ $15 ?$5 1?
*$5 =>5 '= =+5 7>*$5 =>5 '= =+5 7>.= 9 $ 6 76 >=$.= 9 $ 6 76 >=$
15 ?$5 1? 15 ?$5 1?
>5$+5 $319 =>5$+5 $319 =
> 5 = ,$> 5 = ,$3 $+=?=>5 7:3 $+=?=>5 7:
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*6= 3=6$5 2= =$196=?=>51
.=: 6 $+5 7>.=: 6 $+5 7>
$>9$$>9$ 957?$5=/ 957?$5=/= 6 $57?=5 6 = 6 $57?=5 6
7?=56 7?=56 $ $=> 5=> 5??= 6 1 7>??= 6 1 7>
$15= 6 $15= 6
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+6 '7: # . *67+=/96=
+$ +9 $5 7>+$ +9 $5 7>
$6 > 7:$6 > 7:5 = = =5 = = =>?=>5>?=>57> $ 17> $ 1
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# . 6=89 6=1 ' '96 +$
>/9+=/ 15 ?$5 1?
2= 6 2= 6 >+ 1 7>>+ 1 7>
+ $> =1+ $> =15 =5 =
+76 >=$+76 >=$
71=6 5771=6 575 =5 =
+=>56 =+=>56 =5 = ?76 =5 = ?76 =
55+ $> =1+ $> =1
# =# =$6 =6 5 =$6 =6 5 =>+ 1 7>>+ 1 7>
5 = ?76 =5 = ?76 =
55+ $> =1+ $> =1
&$6 $, =&$6 $, =
# = 7># = 7>$ 57 =5$ 57 =5
6 =$17>$, =6 =$17>$, =$2= 6 $ = 1$2= 6 $ = 1
5 &=+576 5 &=+576 $>$ 1 1$>$ 1 1
=15 57=15 57=5=5
+$1=1+$1=155
1$?=1$?=>+ 1 7>>+ 1 7>
.=?=?,=6
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'96 +$ >/9+=/ 15 ?$5 1?
11=11?=>5
7 > 7$/7 > 7$/ ' '$ +9 $576$ +9 $5767 > 7$/7 > 7$/
:67?:67?/7+576 /7+576
+7?+7?
5 > :765 > :76+$1=1+$1=1
#$ = +$6= 57#$ = +$6= 57=5 $ 1 $>/=5 $ 1 $>/
>+ 1 7>>+ 1 7>+766=+5+766=+5
# = +$ +9 $576# = +$ +9 $576$957$957
+$ +9 $5=1 5 =+$ +9 $5=1 5 =''
= 5=?376 $ >+ 1 7> =6 =19 5 $5 /=6 ==1= 5=?376 $ >+ 1 7> =6 =19 5 $5 /=6 ==1= 193=6 76 ?,$ >+ 1 7> = $5 /=6 ==1= 193=6 76 ?,$ >+ 1 7> = $5 /=6 ==1
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' $ +9 $5767 > 7$/ :67? /7+576 +7?
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' .=3765
>+ 1 7> 7+$5 7>
'96 +$ >/9+=/15 ?$5 1?
735=619?,=6 7:*$5 =>51 >+ 1 7> 7+$5 7>
'96 +$ >/9+=/15 ?$5 1?
735=619?,=6 7:*$5 =>51
#=?376$ #=?376$
$1$ $1$
'93=6 76 '93=6 76
>:=6 76 >:=6 76
'93=6 76 #=?376$ '93=6 76 #=?376$
>:=6 76 #=?376$ >:=6 76 #=?376$
2=6$ ' 2=6$ '
. 5 ' =:5
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k h
$ h5
8/4/2019 Pearls for Introducing AcrySof Toric IOL in Practice Dr Suresh K Pandey, SuVi Eye Institute Kota, India
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*6=+ 1==6$57?=56
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=$196 > 5 =V > 5 $5 76 1 = :76 79V 95 (1= $ /=/ +$5=/ =6$57?=5=6 V > 91= +76>=$ =6$57?=56 + ?=$196=?=>51
# 6=:6$+5 2= $15 ?$5 1? 77 :76 / ::=6=>+=1 9>919$ ?=$196=?=>51
V 7 :76 5737 6$3 :76 9>919$ 6=$/ > 13776 89$ 5 ? 6=1 =5+
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$ ,6$5 > 5 =$>9$ =6$57?=5=6
15$, 1 $ 1+ =/9 = :76 6795 >= + =+ 1 7: >1569?=>5$5 7> $15$, 1 $ 1+ =/9 = :76 6795 >= + =+ 1 7: >1569?=>5$5 7> $
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7> 5 91= 6=:6$+5 2= $15 ?$5
VV =$196=?=>51 ?$ >75 $ $ 1 $ 6===$196=?=>51 ?$ >75 $ $ 1 $ 6== =>5 +9 $6 =>5 +9 $6 $15 ?$5 1? ?$ $++79>5 :76 17?= 7:$15 ?$5 1? ?$ $++79>5 :76 17?= 7:
5 1 / 13$6 5 36=5 1 / 13$6 5 36=7373 # 5=/ 76 / 13 $+=/ 367,$, 7> $++79>51# 5=/ 76 / 13 $+=/ 367,$, 7> $++79>51
$ ?$ ?9? 7: $15 ?$5 1? 3715$ ?$ ?9? 7: $15 ?$5 1? 37157373 .=:6$+5 7> ?$ 9>/=6=15 ?$5= 569=.=:6$+5 7> ?$ 9>/=6=15 ?$5= 569= =6$57?=56=6$57?=56 +
$15 ?$5 1?$15 ?$5 1?
$ 1 ? >$6 $ $>$> & =5 $6 + 35 $ ?7 9 $6 / =5 $ .=: 6 $+5 '9 6
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'96 =7> $+576 $5$ +89 1 5 7> 7: .=$/ > 1
V 9 5 3 = .=$/ > 15 1$?= 6=$/ > 1 $6= 7,5$ >=/
V 76= 6= $, = $>9$ =6$57?=56 957?$5=/ =6$57?=56 7> 5 '5=31 7:
V .=$/ > 9 + < $27 / /6 > 7: +76>=$ 7> 5 69, 7> 5 = +76>=$ =>56$5 7>
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$ +9 $576 >3951
' 5h h
Eh
, h # ' h & h
&
kh 5kh k h
k kh
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$ +9 $576 >395 95395
h
h k h h
5 h
h kh h
hk
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#$ = 5 = 36 >5 795 +73 57 5 =
k kh &
8/4/2019 Pearls for Introducing AcrySof Toric IOL in Practice Dr Suresh K Pandey, SuVi Eye Institute Kota, India
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'5==3 1
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$6 > >1569?=>51
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+6 '7: # .
V '9 5$, = +$>/ /$5=1 $6= +$5$6$+5 3$5 =>5136= = 15 > +76>=$ $15 ?$5 1?
76 ?76= 5 5 = :7 7 > + $6$+5
$>9$ =6$57?=56 15==3 $>/ : $5 ?=6 / $>1 =$ 5737 6$3 1 ??=56 +$ $15 ?$5 1?
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# '5$:: $>/ >=15 =5 159 15(>/=615$>/5 = *67+=11
V ==/ 57 1 5 3$5 =>5 93 57 ?$6 76 7>5$,=:76= 1=/$5 7> , 7+ #
V = 196= $ 15$:: >7 5 = # . 3$5 =>5 715 57 ,= 196= 5 $5 >=+=11$6 367+=/96=1 $
:7 7 =/
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$6 > 7: 5 = = .=:=6=>+=$6 >V # 7 15=31
.=:=6=>+= $6 > 1 $6 >
V .=:=6=>+= $6 > *6= >/9+5 7> 3=6 7/ *$5 =>5 > 936 5 371
# 7 6=:=6=>+= ?$6 13 $+=/ $5 5 = ?,91/= 6==1 $3$65
(1=/ $5=6 57 $ > 5 =?$6 > >1569?=>5 :763 $+=?=>5 7: $ 1 ?$6 1
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$6 > :76$ ?9? =>=: 5
V *=> $>/ = =,$
V ' 5 $?3 5 13 /=2 +=
V 7??=6+ $ ?$6 =61
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*6$+5 += 7> >7> # . 1
V 56$ 15=31 >==/=/ :76 #76 + $6 > .75$5 > 57 36=+ 1= $ 1 .=?72 > 2 1+7 = $15 + :67? ,= >/
V 9 /1 +7>: /=>+= $>/ 1
> + $> > 7>= 3$65 7: 796 5=+ > 89= '$:=6 $>/ =11 156=11:9 => 79 15$65
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*6$+5 += 7: 7> #76 + & /=7
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$6 > 7: 5 = = 1$6 >
1 $6 > 1V =: >= 5 = 735 ?$ $ 1 7
3 $+=?=>5V =5=6? >=/ , 5 = +6 '7:
#76 + $ +9 $576 V (1 > 5 = 6=:=6=>+= ?$6 1
$1 $ 9 /= 5 = 3$5 =>5 11 ?$6 =/ $++96$5= $5 5
371 5 7>1 /= 6==1$3$65
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$6 > # 31V 6 5 = +7> 9>+5 2$ 5 $V > $>+= 5 = ?$6 > 1 $5
7+ $>/ + 7+ 371 5V # = 36= 73 ?$6 > 1 ,=15 /7
5 5 = = 3 7: 1 5 $?3 :15$, >
V 33 5 = ?$6 > 3=> 55 15 > ?75 7> +$3 $6 $
+6=$5= $ 5$5577 =::=+5V # = 2 7 =5 ?$6 $15 $
5 ?$ :$/=
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+6 '7: # . >?=>5
6 7 1 1 > ? = > 5
6 7 1 1 > ? = > 5
V .75$5=+ 7+ 1= 57$3367 ^
^ 1 765 7:5 = : >$371 5 7>
V *=6:76? 5 1?$>=92=6
= 5 =1 9>:7 / >5 > 5 =
+$319 $6 ,$
& 1 + 7 = $ 1 5 + . = ? 7 2 $
& 1 + 7 = $ 1 5 + . = ? 7 2 $ V 7> 5 675$5=
3$15>5=>/=/
$ 1 /96 >2 1+7 = $15 +6=?72$
V .=?72= $2 1+7= $15 +
:67?,=>=$5 5 = > $ > ? = > 5
> $ > ? = > 5
V .75$5=+ 7+ 1=36=+ 1=
7>57 5 =>5=>/=/$ 1 7:$ >?=>5
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+6 '7: #76 + ?3 $>5$5 7>> $ *=/ $56 + $5$6$+5 &
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& /=7& /=7
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>567/9+ > #76 + =>1=1 $1 ,==> 7>= 7:
5 = ?715 1 > : +$>5 $/2$>+=1 >
196 +$ 36$+5 += > 5 = $15 =$61
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# $> 1 :76 796 $55=>5 7># $> 1 :76 796 $55=>5 7>
9=15 7> 7??=>59=15 7> 7??=>5
$ 1 9>/=6367? 1=
72=6 /= 2=6
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*=$6 1 :76 >567/9+ > +6 '7:*=$6 1 :76 >567/9+ > +6 '7:
# . > 796 *6$+5 +=# . > 796 *6$+5 +=6 & /91 ' $6?$6 & /91 ' $6?$
' . ' (' . ' (
6 '96=1 *$>/=6 '96=1 *$>/=' 3 5 $ ?7 7 * . .' 3 5 $ ?7 7 * . .>5=6 76 '= ?=>5 = 7 1 3 ('>5=6 76 '= ?=>5 = 7 1 3 ('
'9& = >15 595= $1 $1=6 =>56='9& = >15 595= $1 $1=6 =>56=# # . '## # . '#
* 7>=* 7>==,1 5= 192 = = +7?=,1 5= 192 = = +7??$?$ 192 = = ?$ +7?192 = = ?$ +7?
& 1 5 > 11 15$>5 *67:=1176 7 > 76$> = =>5=6& 1 5 > 11 15$>5 *67:=1176 7 > 76$> = =>5=6(> 2=61 5 7: (5$ '$ 5 $ = 5 (5$ ('(> 2=61 5 7: (5$ '$ 5 $ = 5 (5$ ('
' />= = 713 5$ (> 2=61 5 7: ' />= 9156$ $' />= = 713 5$ (> 2=61 5 7: ' />= 9156$ $