Biography: Waring is the founder and Medical Director of the Waring Vision Institute in Mt. Pleasant, SC.
December 16, 2019
2 min read

BLOG: New toric IOL features haptic modifications

Biography: Waring is the founder and Medical Director of the Waring Vision Institute in Mt. Pleasant, SC.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact

Astigmatism affects nearly half our patients undergoing cataract surgery, but it often goes uncorrected, leaving patients dependent on glasses after surgery. Financial aspects and physician concerns about alignment and rotational stability have been barriers to more widespread implementation of toric lenses, which are the best way to correct astigmatism so that patients can achieve good uncorrected distance vision after cataract surgery.

After working with Johnson & Johnson Vision for the past several years on ongoing advancements in its toric lens platform, I recently had the wonderful opportunity to implant the first commercial Tecnis toric II (ZCU) lenses in the world.

Implantation of a “pure” toric (without presbyopia correction) is increasingly less common in my practice, where most patients who opt for refractive cataract surgery also want to see well at near. Therefore, our first two patients for the Tecnis toric II were slightly unusual cases. The first patient to receive the lens was a professional pilot for a major airline who required a monofocal lens due to FAA regulations and was thrilled with his 20/20 vision on his first postoperative day. The second person to receive the lens was a monocular patient with macular degeneration. In both cases, the toric IOLs were perfectly aligned on postoperative day 1.

Consistent with any other toric IOL, meticulous biometry and preoperative measurement of the astigmatism axis and power, and accounting for posterior corneal astigmatism are essential. Intraoperatively, surgeons will find that the Tecnis toric II is very similar in behavior and appearance to its predecessor, the Tecnis toric ZCT. No changes have been made to the optical design of the lens, so it features the same high-quality, aspheric optics as all other Tecnis IOLs. However, under high magnification, one can appreciate that the ZCU haptics are slightly more squared and frosted than the ZCT haptics. This gives the haptics a subtle texture that that adds stability within the capsular bag, with the goal of further minimizing the low rate of rotation.

In clinical trials that led to FDA marketing approval in December, the ZCU lens demonstrated excellent rotational stability. The company is launching two post-market clinical trials with up to 1,000 patients to demonstrate the rotational stability and visual outcomes offered by the Tecnis toric II platform. I applaud manufacturers who continue to improve and advance IOL technology for the benefit of our patients.


Disclosure: Waring reports he is a consultant for Johnson & Johnson Vision and a member of the Johnson & Johnson Vision optics advisory board.