At least 70 percent of cataract patients could benefit from toric IOL

More than two-thirds of cataract patients could benefit from toric intraocular lenses (IOL), according to findings presented at 100% Optical.

Consultant ophthalmologist Nigel Kirkpatrick set out how astigmatism is a significant issue for cataract surgery patients during a main stage presentation at 100% Optical, at ExCel London, on Sunday 1 March.

Mr Kirkpatrick, who is medical director at NHS and private ophthalmology provider Newmedica, explained that an audit of Newmedica keratometry data covered 2,500 consecutive patients.

‘Putting this data into proprietary toric IOL calculators showed that a toric IOL was recommended in at least 70% of cases even with adoption of steep axis surgical incisions,’ he said after the session.

He highlighted the importance of looking at the K (keratometry) value, explaining that if delta K is greater than 1.2D in with-the-rule (WTR) astigmatism, a toric is recommended. Similarly, if delta K is greater than 0.5D ATR (against-the-rule) astigmatism, again a toric is recommended. Meanwhile, a toric is often required in oblique astigmatism cases.

‘Personalised refractive outcomes are patient-centred care. Optometrists can enable informed choice and protect patients from being defaulted into monofocal limitation,’ said Mr Kirkpatrick.

It underlined, he noted, the importance of informed consent and genuine patient choice that empowered patients. ‘Patient choice must be meaningful. That means giving people clear information, explaining options, and making sure the care they receive reflects their goals and lifestyles.’

Sector collaboration to meet rising patient need

Mr Kirkpatrick’s presentation also reflected more widely on the challenges and opportunities facing the health service. It highlighted major themes from the government’s 10-year plan for health in England shaping the future of care: the shift from hospital to community settings, the move from analogue to digital systems, and a renewed emphasis on prevention.

‘Demand is rising, the pressure is intensifying, and that means we must seize the opportunity to redesign care in ways that genuinely serve patients,’ he said.

Declaring it was optometry’s decade, he added: ‘Optometry already delivers neighbourhood level eye care. It’s one of the few parts of the system already aligned with the direction of travel – and that’s something we should be proud of and build upon.’

The session explored clinical innovation including in cataract, glaucoma and AMD pathways. Examples included digital shared care, virtual review systems, and the increased use of OCT and remote triage tools. Proposed legislation by MP Shockat Adam, an optometrist, was also highlighted by Mr Kirkpatrick as an opportunity to create a nationally directed community glaucoma service in England, with more collaboration between community optometry and ophthalmology.

He also stressed that integration can only succeed if professionals across the sector share common data standards, adopt consistent testing protocols and commit to patient centred decision-making.