Toric vs Non-Toric Lenses for Refractive Lens Exchange

When you’re preparing for Refractive Lens Exchange (RLE), also known Lens Replacement (LR), choosing the right lens implant is an important decision. One key consideration is whether to select a toric or non-toric intraocular lens (IOL), especially if you have astigmatism. At Porter Ophthalmology, we help patients understand the differences between these options so they can feel confident about their choice. In this article, we’ll explain how each lens works, who benefits most, and what to expect after surgery. To find out which lens is right for your vision needs, schedule a consultation with our team at Porter Ophthalmology.

What is the difference between toric and non-toric lenses?

The primary difference is that a toric lens corrects astigmatism, while a non-toric intraocular lens does not. For patients with significant corneal astigmatism, a toric lens can greatly improve visual acuity and reduce reliance on glasses after surgery. Non-toric lenses are more appropriate for those with lower levels of astigmatism that can be reduced with a laser. Both toric and non-toric lenses come in a range of types—monofocal, multifocal, and extended depth-of-focus options—that restore vision but could still leave some refractive error uncorrected if astigmatism is not addressed. Since RLE replaces the natural lens, it also prevents the development of cataracts and cataract surgery in the future.

How does a toric lens correct astigmatism?

A toric intraocular lens is designed to correct the irregular shape of the cornea caused by astigmatism, a condition that can cause blurred or distorted visual perception. The toric lens has built-in power that aligns with the specific orientation of the astigmatism, and when implanted properly, it stays in place for lasting correction. The measurement of corneal curvature is critical to this process and includes corneal topography and advanced imaging to ensure proper alignment. This corrective lens approach allows the surgeon to target astigmatism during the same procedure. At Porter Ophthalmology, we use advanced diagnostic tools and surgical planning to ensure each toric lens is customized for the best possible outcome.

Who is a good candidate for a toric IOL?

A patient is typically considered a good candidate for a toric IOL if they have at least 1.0 dioptre (diopter) of corneal astigmatism. This level of astigmatism, if left uncorrected, can negatively affect distance vision after surgery. Advanced toric lenses can address astigmatism ranging from about 0.75D up to over 4.75D. Patients with minimal astigmatism may not benefit significantly from a toric lens and might achieve similar results with a non-toric lens with an additional procedure like laser relaxing incisions. During your consultation, the team at Porter Ophthalmology will carefully evaluate your corneal measurements to determine whether a toric IOL is the most effective option for your vision goals.

How do non-toric lenses work?

Non-toric lenses restore clarity and correct refractive errors such as presbyopia, but they do not address astigmatism. If astigmatism is present, the patient may still need glasses after surgery or may consider additional options like laser astigmatic keratotomy. Non-toric and toric lenses are available in multiple designs, including monofocal (correcting for one focal point, single distance), multifocal, and extended depth-of-focus lens types, with the latter two potentially improving both near and far vision.

How do the visual outcomes compare between toric and non-toric lenses?

Toric lenses generally provide better uncorrected distance vision in patients with astigmatism, significantly reducing the need for glasses for far tasks. However, uncorrected near visual acuity may be slightly better with non-toric or multifocal lenses, especially when a small amount of astigmatism enhances depth of focus. Both lens types yield strong improvements in quality of life, and while toric lenses reduce glare and optical distortions from astigmatism, the overall visual perception outcomes for daily tasks can be similar when the lens is matched properly to the patient’s needs. Dr. Porter helps each patient weigh these factors to select the lens that best fits their unique visual demands and lifestyle prior to their eye surgery.

Will I still need glasses if I choose a toric lens?

Toric IOLs significantly reduce the likelihood of needing glasses for distance vision, particularly for those with moderate to severe astigmatism. However, most people will still need reading glasses or correction for up-close tasks, as toric IOLs do not fully eliminate the effects of presbyopia—the age-related loss of near vision. During your consultation, Dr. Porter will help you understand what level of independence from glasses you can expect based on your specific prescription and vision goals.

What about near vision and reading without glasses?

Non-toric lenses may provide slightly better uncorrected near vision at distances like 50 cm due to mild residual astigmatism, which can increase depth of field. In contrast, toric lenses provide more accurate distance correction but may reduce this depth of focus, resulting in less clear near vision unless paired with a multifocal or EDOF design, or with blended vision. If reading or working up-close without glasses is a priority, certain lens implant options, such as multifocal or extended depth-of-focus lenses, may be a better fit.

How do the costs compare between toric and non-toric lenses?

Because Refractive Lens Exchange is an elective vision correction procedure, it is not typically covered by insurance. Standard non-toric IOLs are included in the base procedure cost, while toric lenses are considered an upgrade because they correct astigmatism. Patients usually pay an additional fee for this upgrade, often ranging from $900 to $1,500 per eye, and in some cases up to $2,000.

Does a toric lens eliminate the need for other corrective options?

For patients with significant astigmatism, toric lenses can often replace the need for glasses or contact lens wear for distance vision. However, for close-up tasks or reading, especially in cases of presbyopia, most people will still benefit from reading glasses, if they choose a distance goal for both eyes. Some patients may consider combining a toric lens with other technologies, depending on their goals, but this should be discussed with your surgeon based on your specific needs and lifestyle. Dr. Porter takes the time to understand your vision priorities and will walk you through all available options to help you make the most informed decision.

Can the toric lens rotate or shift after surgery?

Yes (although rarely), while toric lenses are designed to stay in place, slight misalignment during healing can occur and affect visual acuity. This is uncommon, but if significant, your surgeon may need to reposition the implant. Proper measurement, corneal topography, and surgical technique all play a role in minimizing this risk and ensuring optimal results. Patients should follow post-op instructions carefully and attend follow-up visits to monitor lens stability. The lens is very unlikely to rotate after the first 24 hours following surgery.

What if I want to avoid any potential complications?

Whether you’re considering a toric lens or non-toric option, your best choice depends on your unique human eye anatomy, visual goals, and lifestyle needs. At your consultation, we’ll assess factors such as your level of astigmatism, overall eye health, and any conditions like myopia or presbyopia, to help you make an informed decision. While every eye is different, working closely with your ophthalmology team will ensure the safest and most effective outcome possible.

Ready to Talk About Your Options?

Choosing the right lens for your Refractive Lens Exchange can feel overwhelming, but our experienced team is here to guide you through every step. If you have astigmatism, we’ll help determine whether a toric lens is the right fit—or whether a non-toric lens will give you the clarity you’re looking for. Don’t leave your vision to guesswork. Schedule a consultation today to learn which option is best for your eyes and your future.

Article Source : eyeporter.com/custom-lens-r...