Astigmatism and Cataract Surgery: Toric Lenses and Other Ways to Fix It
Many people having cataract surgery also have astigmatism, and many don't know it until their measurements come back. The good news is that cataract surgery is the best opportunity you'll ever have to correct it.
What astigmatism is
A normal cornea, the clear front window of the eye, is shaped like a basketball: equally curved in every direction. With astigmatism it's shaped more like a football, curved more steeply one way than the other. Light focuses unevenly, so vision is blurred or stretched at every distance, near and far.
Why it matters in cataract surgery
A standard lens implant replaces your cloudy lens and can set your focus for distance, but it doesn't correct astigmatism in the cornea. If you have a meaningful amount and it isn't treated, you may still need glasses for clear distance vision after surgery, even with a premium lens.
Three ways to correct it
- A toric lens implant. A toric lens has astigmatism correction built into it. During surgery I rotate it to line up precisely with the axis of your astigmatism. Toric versions are available for a standard monofocal lens and for premium lenses, including PanOptix Pro, Vivity, PureSee, Odyssey and enVista Envy.
- Laser incisions during laser cataract surgery. With the LENSAR ALLY laser, I can place precise arcuate incisions in the cornea to reduce smaller amounts of astigmatism. LENSAR uses iris registration to line the treatment up with the true axis, even if your eye rotates slightly when you lie down. More about laser cataract surgery.
- The Light Adjustable Lens. After your eye heals, the lens power, including astigmatism, is fine-tuned with short in-office light treatments, then locked in. It's especially useful after LASIK, PRK or RK. More about lens options.
Which is right for you?
It depends on how much astigmatism you have, where it is, the health of your cornea, and which lens you choose for your range of vision. At your evaluation we measure the cornea in detail, and I'll recommend the approach most likely to leave you seeing clearly.
Does insurance cover it?
Medicare and most insurance cover cataract surgery with a standard lens. Correcting astigmatism with a toric lens, laser incisions or the Light Adjustable Lens is a premium service with an added out-of-pocket cost. We give you a written estimate before surgery. See what Medicare covers in 2026.
Common questions
Can a toric lens move after surgery? Rarely, a toric lens can rotate slightly in the first days. If it does and it affects your vision, it can be repositioned with a short procedure.
I wore toric contact lenses. Does that mean I need a toric implant? Not necessarily. Some astigmatism comes from the natural lens and goes away when the cataract is removed. Your measurements tell us how much is in the cornea.
Call 830-379-3937 to schedule a cataract evaluation in San Antonio, New Braunfels, Seguin or San Marcos.
For educational purposes. This page explains common conditions and treatments to help you prepare for your visit. Your exam determines the right plan for your eyes.
