- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: December 8, 2024
- Last Updated: October 8, 2026
TL;DR: Yes, ICL surgery can correct astigmatism and short-sightedness together using a toric implantable collamer lens (ICL), which has different focusing powers in different directions. In the US regulatory trial of the latest toric lenses with a central opening for fluid flow, patients with astigmatism of up to 4.00 dioptres, a measure of prescription strength, were treated successfully.¹ The two things that decide the result are accurate measurement of your astigmatism and precise alignment of the lens inside the eye.
Astigmatism is corrected by alignment, not just by power. The lens has to sit where it was planned to sit.
What Is Astigmatism?
Astigmatism means the front of the eye is curved more steeply in one direction than the other, like a rugby ball rather than a football. It blurs vision at every distance.
Many people with high short-sightedness also have astigmatism, which is one reason they are referred for ICL rather than laser.
How ICL Surgery Corrects Astigmatism
A toric ICL has different focusing powers in different directions, matched to the shape of your cornea, the clear front surface of your eye. It has to be placed at a specific angle, known as the axis and measured in degrees, so its correction lines up with your astigmatism.
The position is planned and checked at three stages:
- Before ICL surgery, the correct axis is marked on the eye.
- During surgery, the lens is rotated into position.
- After surgery, its position is checked.
How Well It Stays in Place
Rotation matters because a toric lens that turns away from its intended axis corrects less astigmatism. How well it stays at that angle is known as rotational stability.
Research has examined both lens stability and visual results:
- A study comparing earlier toric ICLs with central-port designs, which have a small opening for fluid flow, found good rotational stability with both designs.²
- A 12-month study of toric ICLs for moderate to severe astigmatism reported good visual outcomes.³
- When toric ICLs were compared with combining an ICL and laser treatment for myopic astigmatism, meaning short-sightedness with astigmatism, the toric ICL gave comparable results in a single procedure.⁴
- A broader review of central-port ICLs across more than 2,900 eyes found stable prescription results and low rates of complications. This review covered central-port ICLs generally, rather than toric lenses alone.⁵
When a Single Lens Is Not Enough
For very high or irregular astigmatism, the best result sometimes comes from combining an ICL with laser treatment on the cornea. Our article on laser eye surgery after ICL explains when that makes sense.
Irregular astigmatism, where the cornea’s curvature does not follow a regular pattern, cannot be fully corrected by any toric lens. This is why corneal tomography, detailed scans of the cornea’s shape and thickness, is reviewed before a lens is chosen.
What to Expect From Your Eye Clinic
At Blue Fin Vision®, our eye clinic commits to careful measurement, a defined surgical pathway and ongoing monitoring.
- Measurement. Your astigmatism is measured on corneal tomography and cross-checked before the lens power and axis are chosen.
- If the lens rotates. Repositioning sits within our own surgical pathway. For eligible self-pay patients, a clinically indicated enhancement, an additional procedure to refine the visual result, is provided at no cost to the patient within 24 months.
- For life. Every toric ICL is enrolled in the ICL Lifetime Monitoring Protocol™, with refraction, the measurement of your glasses prescription, checked at every monitoring visit.
Further Reading
- The manufacturer’s guide to the Visian toric ICL.
- The manufacturer’s guide to the EVO toric ICL.
- Our ICL surgery checklist.
- Our online astigmatism test, if you are unsure whether you have astigmatism. It is a starting point, not a diagnosis.
References
- Packer M. Evaluation of the EVO/EVO+ Sphere and Toric Visian ICL: six month results from the United States Food and Drug Administration clinical trial. Clin Ophthalmol. 2022;16:1541-53. doi:10.2147/OPTH.S369467. PMID:35645557.
- Hyun J, Lim DH, Eo DR, Hwang S, Chung ES, Chung TY. A comparison of visual outcome and rotational stability of two types of toric implantable collamer lenses (TICL): V4 versus V4c. PLoS One. 2017;12(8):e0183335. doi:10.1371/journal.pone.0183335.
- Bhikoo R, Rayner S, Gray T. Toric implantable collamer lens for patients with moderate to severe myopic astigmatism: 12-month follow-up. Clin Exp Ophthalmol. 2010;38(5):467-74. doi:10.1111/j.1442-9071.2010.02273.x.
- Choi SH, Lee MO, Chung ES, Chung TY. Comparison of the toric implantable collamer lens and bioptics for myopic astigmatism. J Refract Surg. 2011;27(2):91-7. doi:10.3928/1081597X-20100414-01.
- Montés-Micó R, Ruiz-Mesa R, Rodríguez-Prats JL, Tañá-Rivero P. Posterior-chamber phakic implantable collamer lenses with a central port: a review. Acta Ophthalmol. 2021;99(3):e288-e301. doi:10.1111/aos.14599.
ABOUT THE AUTHOR
Mr Mfazo Hove
Consultant Ophthalmic Surgeon
MBChB MD FRCOphth CertLRS
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with experience spanning more than 57,000 procedures. He completed 6.5 years of specialist training at Moorfields Eye Hospital and served for five years as a consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust. He is the founder of Blue Fin Vision®, a consultant-led private ophthalmology practice operating across London, Essex, and Hertfordshire. His clinical expertise encompasses advanced cataract surgery, refractive lens replacement, laser vision correction, and implantable Collamer lenses (ICL).
A ZEISS Key Opinion Leader, Mr Hove is a respected international speaker with five invited engagements across seven cities in 2026:
- ZEISS China tour (Changsha, Shanghai, and Hangzhou, April – ZEISS APAC User Meeting)
- RCOphth Annual Congress – May – Manchester
- ZEISS EMEA User Meeting (Istanbul)
- ZEISS Lausanne User Meeting (Lausanne)
- European Society of Cataract and Refractive Surgeons Annual Congress (ESCRS, London)
Schedule Your Consultation Today
Book a consultation with Blue Fin Vision® in London, Hertfordshire or Essex to discuss whether ICL surgery could correct your astigmatism.
