What is astigmatism, and why is it not a minor issue?

Ältere Frau mit kurzem grauem Haar und Tuch am Strand im Gegenlicht
In brief

What
A toric lens additionally corrects astigmatism, as a toric ICL or as a toric artificial lens in a lens exchange.
For whom
Astigmatism from about 0.75 D; young patients with high values (ICL), from 50 to 55 with presbyopia or cataract (lens exchange).
Price
€3,500 per eye; correcting the astigmatism does not make the treatment more expensive.
Not suitable
Irregular cornea without prior stabilisation (keratoconus: cross-linking first), unstable prescription.

With astigmatism, light rays are not focused at a single point on the retina but stretched into a line. Letters have “shadows”, light sources fray at night, and reading at a screen becomes extremely tiring.

One of the greatest frustrations in standard medicine: a patient has cataract surgery, receives a simple standard lens, and afterwards still sees the world slightly blurred because the astigmatism was ignored. Distance and reading glasses remain a constant companion.

With a toric premium lens we break through this compromise directly inside the eye.

How is the axis of the toric lens determined?

Calculating and implanting a toric lens forgives no mistakes. While simple clinics rely on standard measurements, at EyeLaser Vienna we use protocols from the world’s leading institutes in the USA and Asia:

Close-up of an eye with a patterned iris

1. Ocular surface optimisation (the tear film)

In top-level medicine the principle applies: garbage in, garbage out (wrong measurements produce wrong lenses). If your tear film is broken (dry eyes), the device measures a “false” astigmatism. We treat dry eyes as a matter of course before the final lens calculation. Only a perfectly smooth corneal surface gives us the true values for your toric lens.

Am I suitable for a toric lens?

Smiling woman at a car window, behind her a man at the wheel giving a thumbs-up

🟢 Green light (ideal conditions):

  • Astigmatism of about 0.75 to more than 6.0 dioptres.
  • Young patients: with extreme dioptres or a thin cornea (EVO ICL Toric).
  • Patients from 50 to 55: with presbyopia or cataract (toric lens exchange).
  • Stable corneal topography without pathological bulging.

🟡 Amber light (careful medical clarification needed):

  • Mild keratoconus: if the corneal weakness has been stabilised by UV cross-linking, a toric EVO ICL can often be the only chance of sharp vision.
  • Dry eyes: the tear film must be treated by “ocular surface optimisation” before the AI measurement so that the axis can be calculated exactly.

🔴 Red light (strict refusal for toric multifocal lenses):

  • Unstable keratoconus (because the corneal curvature keeps changing, a fixed axis would no longer fit after a few months).
  • High short-sightedness under 55 to 60 for lens exchange (because of the massive risk of retinal detachment; here we recommend the toric EVO ICL).
  • Advanced macular degeneration (AMD). (Here, from a medical point of view, usually only surgery with standard monofocal lenses makes sense.)

Prices & services

What does a toric lens cost in Vienna?

Transparent and binding, no hidden costs, no surprises.

FIXED PRICE

Lens surgery including the toric lens
€3,500 per eye
Monofocal, monofocal-plus, toric, EDOF or multifocal: the price is the same. Correcting your astigmatism does not make the treatment more expensive.
Included in the fixed price
✓Care package after the treatment: you take your eye drops for the first days home with you directly from us.
✓Diagnostics and treatment planning: you pay for the entire clinical process, not for the material
✓The procedure: performed by an experienced specialist
✓Structured follow-up checks: according to our quality assurance scheme
✓24/7 emergency availability: you receive the surgeon’s personal mobile number
✓Tax-deductible in Austria: as an extraordinary expense
Cost components: toric lens at EyeLaser Vienna, as of 2026.
Service Amount
Free suitability test (15 min.) €0
Lens surgery including the lens, per eye: any lens type €3,500

How does the implantation of a toric lens work?

Step 1Free suitability test. About 15 minutes, no obligation.
Step 2Detailed preliminary examination. Corneal topography and keratometry determine the power and the axis of the astigmatism. This measurement decides the result.
Step 3The procedure. The lens is inserted and rotated exactly to the calculated axis. About 15 minutes per eye, under anaesthetic drops.
Step 4Check-up the next day: we also check whether the lens sits in the planned axis.
Step 5Structured aftercare. In the rare case that the axis shifts, the lens can be readjusted.

How the procedure works, who it suits and what comes afterwards is described in detail on the page about lens surgery.

How does healing progress after a toric lens?

Day 1Follow-up check at the clinic. We check visual acuity and the axis of the lens: the two belong together. Most people already see well enough for everyday life.
Week 1Do not rub the eye, no heavy lifting, no swimming pool. Drops according to the schedule.
Weeks 2 to 6Visual acuity stabilises. A distortion you were used to for years now disappears. The brain needs a few days for that.
Month 3Final check with a renewed axis measurement.

What happens if the lens rotates?

A toric lens only works in the calculated axis. If it rotates, part of the correction is lost: about 3.3 percent of the effect per degree of deviation. At ten degrees, around a third would be gone.

This is rare, usually in the first weeks, and is the reason why we measure the axis at every check-up instead of only asking about visual acuity. If it occurs, the lens can be readjusted in a short procedure. Modern lens designs with a rough surface have clearly reduced this risk.

What are the risks of a toric lens implantation?

iRotation of the lens: rare, correctable, see above.
iResidual astigmatism if the corneal curvature is irregular. That is why we measure the front and back surface.
iThe usual risks of intraocular surgery: infection, swelling of the central retina, retinal detachment. All rare.
iPosterior capsule opacification: possible months to years later, cleared with the YAG laser in a few minutes.

Why do we often turn away short-sighted patients from 45?

In many places, lens exchange is recommended across the board from the age of 45. We at EyeLaser Vienna do not do that.

Close-up of a woman's brown eye with long eyelashes

If you are highly short-sighted, your eyeball has grown anatomically too long. Your retina is under tension. If we now remove your voluminous natural lens and replace it with a flat artificial lens, the vitreous body moves inside the eye.

The medical consequence: in short-sighted people this massively increases the risk of a dangerous retinal detachment (ablatio retinae)!

If you are highly short-sighted and younger than 55 to 60, we often decline lens exchange for your safety. Instead we evaluate the toric EVO ICL (implantable contact lens), which leaves your own lens and the vitreous body untouched.

The toric upgrade: ICL, EDOF or trifocal?

“Toric” is not a lens model of its own but a property that we can add to any high-end lens to compensate for your astigmatism. Depending on your age and lifestyle we offer:

Patient and ophthalmologist during an examination with the slit lamp microscope
  • Toric EVO ICL (the additional lens up to 45/50): for young patients with a thin cornea or extreme dioptres. The artificial lens is inserted in addition to your own. 100 % reversible.
  • Toric EDOF lenses (from 50, focus on night vision): e.g. PureSee™ Toric or LuxLife Toric. Stepless vision from distance to computer. No halos at night. The cylinder value is integrated directly into the smooth profile.
  • Toric trifocal lenses (from 50, absolute freedom from glasses): e.g. enVista ENVY Toric or PanOptix® Toric. These lenses correct distance, computer, fine reading AND your astigmatism in a single optical masterpiece.

How can astigmatism be corrected?

Comparison: toric premium lens (RLE / ICL) · public cataract surgery (standard) · laser eye surgery (SmartSight / LASIK)
Feature Toric premium lens (RLE / ICL) Public cataract surgery (standard) Laser eye surgery (SmartSight / LASIK)
Correction of astigmatism 🥇 Yes, excellent (integrated in the lens) No (glasses mandatory afterwards!) 🥇 Yes (directly on the cornea)
Suitable for a thin cornea? 🥇 Yes (EVO ICL Toric) Yes No (often not possible)
Cataract protection 🥇 Yes (with lens exchange) Yes No
Precision (AI calculation & TCA) 🥇 Yes (highest surgical precision) No (manual standard surgery) 🥇 Yes (7D eye tracking)
Close-up of a green-blue eye with long eyelashes

2. TCA (total corneal astigmatism) & SIA

Many standard devices measure only the front surface of the cornea. That is not enough.

  • TCA: with our high-resolution OCT (MS-39 AXL) we also scan the back surface of your cornea. We calculate the entire, true astigmatism.
  • SIA (surgically induced astigmatism): every surgical access incision into the eye, however small, minimally changes the tension of the cornea. Our AI algorithms (such as the Kane Toric Formula) proactively factor this tiny astigmatism caused by the surgery itself into the power of the artificial lens. That is mathematical perfection.
Nahaufnahme eines blauen Auges mit bräunlichem Ring um die Pupille

3. Rotational stability with lens exchange and EVO ICL

In optics the 3-degree rule applies: if a toric lens rotates by just a few degrees after surgery, it loses a great deal of its effect. How do we secure the lens?

  • With lens exchange (RLE): we remove the natural lens with ultrasound (phacoemulsification) through an incision of 2.2 to 2.4 mm, place the toric lens in the capsular bag and rotate it exactly to the calculated axis. At the check-up the next day we check whether it sits in the planned axis; in the rare case that the axis shifts, the lens can be readjusted.
  • With the EVO ICL: the size of the lens must fit to the micrometre so that it cannot rotate in the eye. We do not estimate, we measure the space behind your iris (sulcus) three-dimensionally with the MS39 to order the exact lens size.
Book a free eligibility check in Vienna now (15 min.)
Dr. Victor Derhartunian seated in the laser suite between SCHWIND laser systems

“Implanting a toric lens separates the wheat from the chaff in refractive surgery. If we miss the axis by a hair’s breadth, the patient is unhappy. That is why we leave nothing to chance. We use OCT (MS-39 AXL) for the posterior astigmatism and AI formulas for calculating the surgically induced astigmatism (SIA). That is an immense medical and technological effort, but it is the only way to guarantee you uncompromisingly sharp and distortion-free vision for the rest of your life.”
– Dr. med. univ. Victor Derhartunian, FEBO, FWCRS

How will you experience the world with a toric lens?

Make no compromises with astigmatism. Invest in the highest retinal safety, AI-supported lens calculation (TCA), FLACS centring and the surgical expertise of Dr. Derhartunian.

100 % without obligation. No hidden costs. Practice in a prime location in the heart of Vienna.

Explained in the video

Toric lenses: when, why and how, explained in the video (in German).

Frequently asked questions (FAQ) about toric lenses in Vienna

What is the difference between a normal and a toric artificial lens?

A standard artificial lens (spherical) has the same refractive power in all directions. A toric lens is like a tailor-made optical suit: it has a different refractive power in one very specific axis in order to compensate exactly for the irregular oval shape of your cornea (astigmatism) inside the eye.

Does the Austrian health insurance (ÖGK) pay for the toric lens?

As a rule, no. If you have cataract surgery, the public insurer pays only for a standard lens that ignores astigmatism (you will need distance and reading glasses afterwards). The upgrade to a toric lens (or even a toric trifocal lens for complete freedom from glasses) is a private service, which you can however deduct from tax.

What happens if the toric lens rotates in the eye after surgery?

A toric lens must sit in the calculated axis. Rarely, it rotates slightly in the first weeks, and vision becomes less sharp again. That is why we check the axis position at every follow-up. If the lens has rotated, we realign it in a short procedure.

Is the procedure painful?

No. Your eyes are completely numbed locally with drops. The procedure takes only about 10 to 15 minutes per eye. You feel only slight pressure, but no pain at all.

Are there toric lenses for presbyopia too?

Yes, that is the “top class”. The latest EDOF and trifocal lenses (e.g. ODYSSEE Toric, ENVY Toric, PureSee Toric) combine everything: they correct short-sightedness, long-sightedness, presbyopia AND astigmatism at the same time.

What is a toric EVO ICL?

For patients (often under 45 to 50) whose cornea is too thin for a laser or for whom lens exchange would be too risky because of short-sightedness, we implant the toric EVO ICL. This is a wafer-thin, biocompatible (Collamer) additional lens that is placed in the eye in addition to your own lens. It is 100 % reversible.

Will I feel the toric lens in my eye?

Absolutely not. Because there are no pain nerves inside the eye and the lens is placed in the tissue with micrometre precision, you feel the implant neither when blinking nor when rubbing.

How long does the artificial lens last?

The biocompatible materials (acrylate or Collamer) do not decompose. The lens lasts your entire life and never needs to be replaced.

Can I still get a cataract after a toric lens exchange?

No. Because your natural lens, which is prone to clouding, has been removed and replaced with an artificial lens, you are protected from cataracts for life. (Note: this applies only to lens exchange, not to the EVO ICL.)

What is a posterior capsule opacification and how is it treated?

Months or years after a lens exchange, the tissue capsule in which the new lens sits can become slightly cloudy (posterior capsule opacification). Vision becomes milky. We “polish” this capsule painlessly in our practice with a YAG laser in 60 seconds. After that, vision is crystal clear for good.

How is the correct axis found during surgery?

We mark your eye before surgery, taking cyclotorsion (the natural rotation of the eye when lying down) into account. Combined with our high-precision preoperative AI calculations (TCA, SIA), the lens is aligned to the calculated axis with millimetre precision under the surgical microscope.

When will I see sharply after the operation?

Visual recovery is rapid. As early as the first day after surgery most patients see excellently in the distance and, above all, without the familiar astigmatic distortions.

When can I work again?

Most patients are fit for work again 2 to 3 days after the operation and can work at a screen. You should avoid heavy physical work for 1 week.

How long do I have to wait for sport?

Light sport (jogging, exercise bike) is allowed after 3 to 4 days. Swimming (lakes, thermal baths) and sauna are strictly forbidden for 3 weeks to avoid serious bacterial infections inside the eye.

May I drive myself after the operation?

Absolutely not on the day of surgery. At the medical check-up the next day the doctor gives you clearance as soon as the legally required visual acuity has been reached.

Why must I not use face cream or make-up on the day of surgery?

Make-up particles and cream vapours endanger the absolute microbiological sterility in the operating theatre. Come with a freshly washed, “bare” face.

May I wear make-up after the procedure?

Please refrain completely from eye make-up for at least 1 week to prevent infections.

Why must I not wear contact lenses before the preliminary examination?

Contact lenses deform the cornea and falsify the OCT values we absolutely need to calculate the astigmatism and the axis of your toric lens to the micrometre. Leave soft lenses out for 1 week and hard lenses for 4 weeks before the examination.

Are both eyes operated on the same day?

With the ICL, we often operate on both eyes on the same day. With lens exchange, both eyes are usually operated on in the same session, each as a separate procedure with its own instruments. On request, we operate on them on separate days.

Is blindness possible as a result of the procedure?

The risk of a serious complication up to blindness is extremely low (well below 1 in 10,000). The greatest theoretical danger is an infection. We minimise this risk uncompromisingly through highly sterile surgical conditions (class 1 operating theatre) and strict hygiene protocols.

Why do you often turn away short-sighted people under 60 for lens exchange?

Short-sighted eyes are longer, the retina is under tension. If we remove the body’s own lens and insert a flat artificial lens, the vitreous body moves. The risk of retinal detachment rises. We do not expose you to this risk unnecessarily and instead often recommend the toric EVO ICL.

Can I drive at night with toric lenses?

Yes, excellently! By correcting the astigmatism, the disturbing “frayed” lights (starbursts) disappear. If you also choose a toric EDOF lens, you have practically no halos (rings of light), which is ideal for frequent drivers.

Why does the preliminary examination at EyeLaser take almost two hours?

Calculating a toric lens forgives no mistakes. The optical AI measurement, the measurement of the posterior corneal astigmatism (MS39), ocular surface optimisation and the retinal check with dilated pupils take time. Added to this is the detailed medical consultation.

How much do toric lenses cost in Vienna?

Toric lenses cost €3,500 per eye at EyeLaser, exactly the same as every other lens. Monofocal, monofocal-plus, toric, EDOF or multifocal: the price is identical.

With us you do not pay for the lens model but for the entire clinical process: the diagnostics, the calculation and selection of the lens, the surgery and the aftercare. Because the choice of lens does not change the price, it is made purely on medical grounds.

This is particularly important with the toric lens: whether your astigmatism is corrected with a toric lens is decided by the measurement alone. It does not make your treatment more expensive. The femtosecond laser can be added as an option (€1,000).

Do you offer payment in instalments?

Yes, in cooperation with our reliable financing partners we offer convenient instalment models.

Can it happen that the dioptres are not hit 100 %?

Yes. Because every body heals individually, in rare cases (about 2 to 5 %) a small residual error or a minimal residual cylinder remains. This is where our EyeLaser quality promise applies: we can usually perfect the optical result without any problem through a fine laser touch-up on the cornea (e.g. with Trans-PRK).

What patients say

Reviews

4.9 out of 5 from 244 Google reviewsAll reviews on Google →Patient stories with video →

„I was looked after excellently and kindly by the EyeLaser team and decided on ICL lens surgery as a result. You are given all the information you need for the operation and for the time afterwards.”

Thomas M. · Google review (translated from German), July 2026

„From the very first moment I felt in the best hands with Dr. Derhartunian. The whole team is incredibly friendly, well organised and really takes time for every patient.”

Ralf P. · Google review (translated from German), July 2026
Read on

What comes next?

Toric means: astigmatism is corrected as well. Where else this works and how to continue:

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