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Toric IOL calculator makes (ocular surgery) news

I’ve recently done some work related to vector planning and the Alpins Method of astigmatism analysis, which is included in the ASSORT program. It was gratifying to see ASSORT recognized recently for its toric intraocular lens (IOL) calculator, offered free online. The calculator was covered by an August 25, 2013, news article in Ocular Surgery News.

Screen shot of the ASSORT Toric IOL Calculator.

Screen shot of the ASSORT Toric IOL Calculator.

The definition of a toric IOL can be found in the Wikipedia entry for intraocular lens. In general, it’s an IOL for people with cataracts who also have astigmatism. I wrote a recent blog post on people with astigmatism who are interested in laser-assisted in situ keratomileusis (LASIK).

I’ll let you read the Ocular Surgery News article for the particulars of the online calculator. But here’s what’s cool: In a comment to the article, the president of the American Society of Cataract and Refractive Surgery, Eric D. Donnenfeld, MD, wrote:

The Alpins Assort Toric IOL calculator is a comprehensive approach to the management of sphere and astigmatism in cataract surgery with the use of any commercially available toric IOL. The toric IOL calculator determines the spherical equivalent of the IOL using SRK/T, Holladay or Hoffer Q formula. In addition, the effective lens position is determined by using the A-constant and surgeon factor based on previous outcomes, and the spherical power of the IOL is factored into the calculation of toric power of the IOL at the corneal plane. The most common source of suboptimal outcomes with toric IOLs is the lack of consideration of the effect of the cataract incision on altering the final cylindrical axis. The Alpins calculator employs vector analysis of the cataract incision into the final axis of IOL placement. Postoperative mathematical analysis of the sphere and axis of the IOL is available for the management of refractive surprises. Alpins has made a significant contribution to cataract surgery with this website. [emphasis added]

And a shout-out to Ocular Surgery News, whose web content is managed by publishes websites for a number of different medical specialties, and recently won the 2013 APEX Grand Award in the website category.

I’ve known Noel Alpins, developer of the Alpins Method, since the early 1990s. The concepts he’s published over the years are not easy to understand. In fact, talking with him often made me feel like the Steely Dan lyrics in “Reelin’ in the Years“:

You been tellin’ me you’re a genius
Since you were seventeen
In all the time I’ve known you
I still don’t know what you mean

Actually, after 20 years or so, the Alpins Method is starting to sink in. I see the genius in it. And, after many years, it seems that so has the rest of the ophthalmology community.

Hey, it’s complicated. We needed time. But it’s also incredibly useful and important. If you have astigmatism and are considering LASIK or cataract/IOL surgery, or have a family member facing either of these procedures, the Alpins Method is worth knowing–and asking your doctor–about.


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