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Soflex Toric Lenses

By

Moodi Kuperman B.Sc.


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Astigmatism
Astigmatism is the most common refractive problem. It is a vision problem that causes objects to appear distorted and blurry. It often affects both distance and near vision. It is the most common vision problem and it may occur with nearsightedness and farsightedness.

Astigmatism
Astigmatism is mostly caused by the cornea having an oblong shape, like a football, instead of spherical shape, like a basketball. A cornea with astigmatism has two curves, one flat curve and one that is steep. Light is then focused at two points instead of one. One point of focus may be in front of the retina and the other behind. This causes images to appear distorted in addition to appearing blurry. Astigmatism may also be caused by an irregularly shaped crystalline lens. This condition is termed "lenticular astigmatism."

More then 40.0% of the population has astigmatism of more than 0.75DS
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Type of Astigmatic Cases


Corneal cylinder Lenticular cylinder

Combination cylinder

Type of Astigmatic Cases


1. Corneal: All the value of the cylinder is from the cornea : CYL=Rh - Rv (in diopter)

Back toric lens is recommend to correct this type of cylinder. Front toric is a limited choice
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Type of Astigmatic Cases


2. Lenticular:
All the cylinder is from the internal part of the eye. Only Front Toric lenses can correct this type of cylinder.

Type of Astigmatic Cases


3. Combination Cylinder:
The Cylinder is vectors sum of the corneal and the lenticular astigmatism.
cornea lenticular l total
The same direction Opposite direction Opposite direction Different direction

Correct with back & front toric lens

Correct with back & front toric lens

Correct with front toric lens

Correct with front toric lens


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How to correct astigmatism?


Using of:

Spectacles Contact lenses Operation


Lasik Intacts IOL
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How can contact lenses help?


Contact lenses help by correcting the distortion of the corneal shape. Considerable advances have been made in correcting astigmatism by contact lenses. Today various types of contact lenses are available to correct almost all types of astigmatism. Contact lenses are better than the conventional eye glasses in correcting some astigmatism cases.

Types of contact lenses used to resolve astigmatism:


Material Lens type Cyl source
Soft Spheric Back toric Front toric GP Spheric Corneal Corneal Any Corneal

Size
Up to -1.00DC Any Up to -2.50DC Up to -2.75DC

Back toric Front toric Bi toric

Corneal Any Any Up to -2.50DC Combination Any


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SOFLEX Soft Back Toric lenses


Toric Lite , Trios, SH Toric (Silicone Hydrogel)

Back toric lens Prism ballast stabilization Large range of parameters Superb comfort High reproducible rate Excellent visual acuity

NO 1

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Back Toric Lens Design


Front surface Back surface Cross-section

Foz = 8.7

Boz = Dt = 8.6m 14.5mm m

Lenticular carrier curve

Anterior optic zone

Lens mark

Eccentric lenticular zone

Peripheral curve Toric optic zone Spherical fitting curve

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Back Toric Lens Design


Stabilization with Prism ballast
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prism

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Back toric

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Up thin Down thick

Force the lens Force the back Force the lens down by gravity toric structure down in each to fit the corneal blink astigmatism
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Lens Parameters:
Base Curve Range: Diameter: Sphere Power Range: Cylinder Power: Axis: Effective Optic Zone: 8.1 , 8.4 , 8.7 , 9.0 , 9.3 13.5 , 14.50 , 15.0 mm ANY ANY ANY 9.00 mm

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Toric-Lite / Trios - Lens Materials


GM3 58% water content hydrogel material
provides :

Extreme comfort
Water retention Low modulus Deposit resistance Durability Increased moisture during wear

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SH Toric - Lens Materials


DEFINITIVE 74% w/c Silicon Hydrogel
material provides :

Extreme comfort
High Oxygen permeability Water retention Low modulus Deposit resistance Durability Increased moisture during wear
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Fitting Procedure:

Patient History along with Normal Slit Lamp Evaluation for C/L Corneal / topography measurements Rh/axis , Rv evaluate the type of the cylinder: Corneal, Lenticular or Combination Back toric design works the best where most of the cyl. is corneal. Base curve : Kflat + 0.8 to 1.0mm for the Toric Lite / Trios Kflat + 0.5 to 0.7mm for the SHToric Spectacle Rx
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Fitting Procedure: cont.

Correction for the back vertex for the sphere and for the cyl. For hyperops, add +0.25DS to the sphere For accurate results, when fitting hi-myopes or hi-hyperops cases, it is recommend to fit first one day disposable lens with the closest sphere power (B.V.P) and then to do over refraction

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SOFLEX Toric Lens Calculator


Advanced PC program for calculating the Soflex Toric lenses that takes into account as much parameters as possible:
The type of the cylinder Size of the cornea Atmosphere (dry or wet) Input parameters:
Diopter or mm + cyl or cyl

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Toric Lens Calculator

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Fitting Example:
Rh= 7.94 (42.50DS) Rv= 7.42 (45.60DS) 42.50 / 45.60 X 165o Rx= -6.25/-3.00x165o Order 7.94+1.0 = 8.94 B.C. = 9.0mm the cyl is corneal. -5.75/-2.50x165o

Toric Lite 14.5 9.0 (SH Toric 14.5 8.7) -5.75/-2.50x175o

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Troubleshooting:
When the vision is not satisfactory : 1. Re-check your fitting. 2. Over refract, and calculate Cross Cyl. and order new lens. Where lens does not stabilize - change BC Where lens rotates recalculate according to the L A R S rule

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The L A R S Rule:
Left Add Right Subtract

Cyl axis + Movement axis

Lens Axis to Order:


Cyl axis

Cyl axis + Movement axis

Left Movement

Right Movement
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Fitting Tips:
The lens can mask axis error up to 8o Order diameter 13.5 / 15.0 when cornea has small / big diameter or according the eye lids space

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CDGM3 FT / SH SPHERE - FT Front Toric hydrogel lens


When the cylinder source is lentiqular or combinate use the Front Toric lens design Front toric lens Prism ballast stabilization Large range of parameters Superb comfort High reproducible rate Excellent visual acuity

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Lens Parameters:
Base Curve Range: Diameter: Sphere Power Range: Cylinder Power: Axis: Effective Optic Zone: 7.6 to 9.0 @ 0.2mm steps 13.5 , 14.50 , 15.0 mm ANY 0.25 to -2.75 @ 0.25D steps ANY 9.00 mm

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Lens Care
Daily cleaning Daily disinfecting

with proprietary brands of: - hydrogen peroxide system - one step system - multi purpose solution system

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THANK YOU VERY MUCH !!


QUESTIONS PLEASE

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