Two separate problems in one eye
A cataract is clouding of the lens inside the eye. Astigmatism is a shape problem of the cornea at the front. Removing the cataract clears the clouding and, with a well calculated implant, corrects nearsightedness or farsightedness. It does nothing to the cornea's shape. If the cornea has significant astigmatism, light still focuses at two points and vision is still blurred without glasses, even though the cataract is gone.
How you find out
Your glasses prescription gives a first indication: a cylinder value of about 1 diopter or more in the prescription usually means corneal astigmatism worth correcting. The evaluation measures the cornea directly with topography and tomography, including its back surface, and distinguishes regular astigmatism, which a toric lens corrects well, from irregular astigmatism caused by keratoconus or scarring, which needs a different plan.
The two ways to correct it during surgery
A toric lens implant carries the correction in its optic and is rotated to the axis of your astigmatism during surgery; it handles moderate and high amounts and comes in monofocal, extended depth of focus and multifocal versions. For smaller amounts, arcuate incisions in the cornea, made with a femtosecond laser where available, relax the steep meridian. Where available, image guidance aligns either method to the planned axis, and intraoperative aberrometry can confirm the axis after the cataract is out.
What to expect
Most patients with a toric lens see clearly at distance without glasses, and residual astigmatism is usually well under a diopter. A monofocal toric lens still leaves reading glasses; a multifocal or extended depth of focus toric lens addresses near vision too. Insurance covers the cataract surgery and a standard lens; the astigmatism correction is an additional cost quoted in writing before surgery.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is what is affecting your vision is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
