Laser correction for astigmatism
Adults with stable sphere, cylinder and axis within the labeling of the exact Visian ICL Toric model used by KazRIED.
About the service
Visian ICL Toric is a phakic toric lens that corrects refractive error and astigmatism while preserving the natural lens. It is placed behind the iris after calculating its power, size and implantation axis.
Who the service is for
Keratoconus and ectasia
Patients with regular astigmatism confirmed by refraction and corneal imaging, without active ectasia or another condition requiring a different strategy. Astigmatism is confirmed by refraction and corneal topography/tomography; the doctor has excluded marked irregularity, ectasia and other causes that toric optics alone cannot correct.
Natural lens
Patients with a clear natural crystalline lens and preserved accommodation when lens removal offers no clinical advantage. A clear natural lens and a clinical reason to preserve natural accommodation.
Endothelial cells
Patients with sufficient anterior chamber depth, safe angle anatomy and an age-appropriate endothelial cell density.
Astigmatism
A Visian ICL Toric consultation is appropriate when a patient has stable ametropia with clinically significant regular astigmatism and an intraocular refractive option is being considered instead of corneal laser surgery. Stable ametropia with regular astigmatism within the approved range of the exact Visian ICL Toric model used.
Corneal suitability for correction
Corneal parameters or the expected laser ablation profile make corneal correction less suitable, while anterior-segment anatomy is appropriate for a phakic IOL.
Astigmatism
The patient understands that Visian ICL Toric is intraocular surgery requiring accurate toric-axis positioning and long-term follow-up .
Laser correction for astigmatism
Visian ICL Toric is mainly considered for stable regular astigmatism combined with a spherical refractive error when anterior-segment anatomy meets the requirements of the exact model. It is not a universal treatment for every type of astigmatism. Patients willing to attend postoperative and long-term checks of IOP, vault, crystalline-lens clarity and toric-axis position.
Corneal thickness
Astigmatism, high myopia or a thin cornea alone does not automatically make a patient eligible.
Pregnancy and breastfeeding
Elective refractive surgery is usually deferred during pregnancy and breastfeeding until refraction stabilises.
Cataract and lens condition
Cataract or clinically significant crystalline-lens opacity.
Anterior chamber angle
Insufficient anterior chamber depth, narrow angle or anatomy outside the requirements of the selected model.
Endothelial cells
Inadequate corneal endothelial cell density.
Glaucoma and eye pressure
Uncontrolled glaucoma or ocular hypertension, active uveitis, intraocular infection and selected corneal disorders.
Refractive stability
Unstable refraction, which would quickly make the lens calculation outdated.
Retinal condition
Retinal or optic-nerve disease may limit visual potential despite accurate refractive correction.
Risks of the procedure
Risks include IOP elevation, inflammation, infection, endothelial cell loss, inappropriate vault, cataract, glare/halos, residual refractive error or cylinder, lens rotation/decentration and the possible need for repositioning, exchange or explantation.
The patient undergoes comprehensive diagnostic assessment
Refraction, keratometry, corneal topography or tomography, anterior-segment biometry, endothelium, intraocular pressure, crystalline lens and retina are assessed.
Laser correction for astigmatism
The doctor calculates the spherical and cylindrical power, size and planned orientation axis of the Visian ICL Toric lens.
When urgent care is needed
Sudden visual loss, increasing pain, marked redness, photophobia, nausea with eye pain or rapid deterioration after surgery requires urgent ophthalmic assessment.
Limitations and safety
Sudden visual loss, increasing pain, marked redness, photophobia, nausea with eye pain or rapid deterioration after surgery requires urgent ophthalmic assessment.
Book a consultation
Stages
Stage 1
Comprehensive assessment
Assessment checks refraction, the cornea, anterior segment, endothelium, pressure, lens and retina.
Stage 2
Lens calculation
The doctor calculates the spherical and cylindrical power, size and planned orientation axis of the Visian ICL Toric lens.
Stage 3
Model and axis verification
The surgeon selects the lens model and individual preparation plan from the findings.
Stage 4
Lens implantation
The folded lens is inserted through a small corneal incision, positioned behind the iris in front of the natural lens and aligned to the planned toric axis.
Stage 5
Postoperative review
Postoperative assessment includes IOP, lens position, vault, residual refraction and agreement between actual and planned toric axis; clinically relevant rotation is managed by the surgeon.
Service benefits
Correcting astigmatism alongside myopia
A toric ICL addresses cylindrical and spherical refractive components in one lens.
Preserving the natural lens
A phakic lens supplements the eye’s optical system without removing the clear natural lens.
No laser removal of corneal tissue
Correction is achieved with an additional intraocular lens rather than laser reshaping of the cornea.
Calculating lens power and size
Individual measurements help select Visian ICL power and size for the eye’s anatomy.
Methods comparison
Criterion
Visian ICL Toric
Visian ICL
Corneal laser correction
Refractive lens exchange
Primary role
Sphere + regular astigmatism with the natural lens retained.
Spherical correction without a dedicated toric component.
Corneal reshaping; astigmatism may be treated within method limits.
Refractive correction after natural-lens removal.
Natural lens retained
Yes.
Yes.
Yes.
No.
Natural accommodation
Preserved if present before surgery.
Yes.
Yes.
Lost.
Effect on the cornea
No refractive ablation.
No refractive ablation.
Corneal tissue is reshaped/removed depending on method.
No refractive ablation.
Intraocular surgery
Yes.
Yes.
No.
Yes.
Astigmatism
Toric component is calculated for cylinder and axis.
Clinically relevant cylinder may remain.
Often treatable within method limits.
A toric pseudophakic IOL may be used.
Anterior chamber/endothelium
Critical eligibility and follow-up factors.
Critical factors.
Not the primary limiting factor.
⬜ Evaluated under different criteria.
Corneal thickness/shape
Thin cornea does not automatically exclude ICL, but irregular astigmatism/ectasia requires separate assessment.
Thin cornea does not automatically exclude ICL.
Pachymetry/topography and ectasia risk are central.
No corneal refractive tissue removal.
Vault and axis
Both vault and actual toric axis require follow-up.
Vault requires follow-up.
⬜ Not applicable.
⬜ Phakic-ICL vault not applicable.
Residual cylinder risk
May occur with calculation error, rotation or irregular astigmatism.
The lens itself does not provide dedicated cylinder correction.
Depends on baseline astigmatism and method.
Depends on toric IOL power and axis.
Removal/repositioning
Removal, exchange or repositioning may be possible when indicated.
Lens may be removed/exchanged.
Corneal change cannot be undone.
The natural lens cannot be restored.
Visian ICL Toric
Primary role
Natural lens retained
Natural accommodation
Effect on the cornea
Intraocular surgery
Astigmatism
Anterior chamber/endothelium
Corneal thickness/shape
Vault and axis
Residual cylinder risk
Removal/repositioning
Sphere + regular astigmatism with the natural lens retained.
Yes.
Preserved if present before surgery.
No refractive ablation.
Yes.
Toric component is calculated for cylinder and axis.
Critical eligibility and follow-up factors.
Thin cornea does not automatically exclude ICL, but irregular astigmatism/ectasia requires separate assessment.
Both vault and actual toric axis require follow-up.
May occur with calculation error, rotation or irregular astigmatism.
Removal, exchange or repositioning may be possible when indicated.
Spherical correction without a dedicated toric component.
Yes.
Yes.
No refractive ablation.
Yes.
Clinically relevant cylinder may remain.
Critical factors.
Thin cornea does not automatically exclude ICL.
Vault requires follow-up.
The lens itself does not provide dedicated cylinder correction.
Lens may be removed/exchanged.
Corneal reshaping; astigmatism may be treated within method limits.
Yes.
Yes.
Corneal tissue is reshaped/removed depending on method.
No.
Often treatable within method limits.
Not the primary limiting factor.
Pachymetry/topography and ectasia risk are central.
⬜ Not applicable.
Depends on baseline astigmatism and method.
Corneal change cannot be undone.
Refractive correction after natural-lens removal.
No.
Lost.
No refractive ablation.
Yes.
A toric pseudophakic IOL may be used.
⬜ Evaluated under different criteria.
No corneal refractive tissue removal.
⬜ Phakic-ICL vault not applicable.
Depends on toric IOL power and axis.
The natural lens cannot be restored.
Book an appointment
Book a KazRIED consultation so the ophthalmologist can measure refraction and astigmatism, evaluate ocular anatomy, determine whether toric correction is required and confirm whether the available Visian ICL Toric is suitable for you.
Procedure prices
Service name
Price
Posterior chamber phakic Visian ICL Toric implantation (excluding the IOL cost) (per eye)
from 486 000 ₸
Posterior chamber phakic Visian ICL implantation (excluding the IOL cost) (per eye)
from 453 000 ₸
Our doctors
A team of experienced doctors across specialties.
Experience: 13 years
Ophthalmologist
Kalshabekov Alibi Sembaevich
Highest-category ophthalmologist
Experience: 9 years
Ophthalmologist
Kalmurzaev Kanat Kayratuly
Second-category ophthalmologist
Experience: 10 years
Ophthalmologist
Kazankapov Gumarzhan Kuanyshevich
Visian ICL Toric: Features, Lens Selection and Astigmatism Correction
Visian ICL Toric is a posterior chamber phakic intraocular lens. The eye's natural crystalline lens is preserved during implantation, while the toric optics provide a cylindrical component to correct astigmatism alongside the spherical refractive error. The lens is positioned behind the iris and in front of the anterior capsule of the natural crystalline lens.
Both optical power and precise axis alignment are essential for a toric lens. If the lens rotates away from its planned position after implantation, some of the cylindrical correction may be lost, resulting in residual astigmatism. Clinically significant rotation may occasionally require lens repositioning. Accurate axis calculation and postoperative monitoring of lens orientation are therefore important aspects of treatment.
Surgery Cost
The stated surgical fee does not include the cost of the intraocular lens (IOL).
Astigmatism Correction
The selection of Visian ICL Toric depends on the degree of myopia, the type of astigmatism, corneal condition and the results of a comprehensive diagnostic examination.
- Stable high myopia and regular astigmatism. If the cornea is unsuitable for the selected laser vision correction procedure, an extended diagnostic examination is performed. This includes calculating the spherical power, cylindrical power, size and axis of the Visian ICL Toric. The decision regarding implantation is made based on the examination results.
- Myopia with a small cylindrical component. If comprehensive calculations indicate that a toric ICL is unnecessary, the ophthalmologist compares Visian ICL Toric with the non-toric Visian ICL. The appropriate option is selected without unnecessary toric correction.
- Irregular astigmatism or suspected keratoconus. Corneal tomography is performed. Visian ICL Toric is not selected automatically. The underlying corneal condition and the subsequent refractive treatment strategy must be assessed first.
- Older age, reduced accommodation or early cataract. Visian ICL Toric is compared with refractive lens exchange and implantation of a toric pseudophakic IOL.
Lens Selection and Postoperative Monitoring
Selecting a Visian ICL Toric requires simultaneous determination of the spherical power, cylindrical power, axis and lens size. The ophthalmologist assesses manifest and cycloplegic refraction, the stability of cylindrical power and axis, keratometry, and corneal topography and tomography.
Additional assessments include anterior chamber depth and angle, corneal endothelial cell density, anterior segment dimensions, intraocular pressure (IOP), and the condition of the crystalline lens, retina and optic nerve.
Two key parameters are monitored after surgery: vault (the distance between the ICL and the natural crystalline lens) and the actual orientation of the toric lens.
Criteria for the Specific Lens Model
FDA labeling for Visian Toric ICL in the United States includes restrictions related to patient age, the range of myopia and cylinder, anterior chamber depth and refractive stability. These criteria are specific to the lens model and regulatory region.
FDA restrictions should not automatically be considered the eligibility criteria of KazRIED without confirmation of the specific lens model supplied to the institute.
Assessment of Corneal Ectasia Risk
Irregular astigmatism, keratoconus and other forms of corneal ectasia require separate assessment before Visian ICL Toric is considered.
A toric lens is designed to correct a specific cylindrical component of refractive error. It does not treat pathological changes in corneal shape. Therefore, when ectasia is suspected, the corneal condition must be evaluated and the treatment strategy for the underlying pathology determined first.
Myopia
High myopia requires a thorough examination of the peripheral retina.
If a patient also has cataracts or significant presbyopia, the ophthalmologist compares ICL implantation with refractive lens exchange, taking the examination findings into account.
Facts and offers
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
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Frequently asked questions
What is Visian ICL Toric?
It is a posterior chamber phakic Collamer lens from STAAR Surgical with a toric component. It is implanted while preserving the natural crystalline lens and is designed to correct refractive error with astigmatism in suitable patients.
How does Visian ICL Toric differ from standard Visian ICL?
The toric model additionally corrects the cylindrical component of refractive error, or astigmatism. A non-toric ICL is used when separate cylinder correction is not required.
Are Visian ICL Toric and EVO Toric ICL the same?
Not necessarily. EVO Toric is a newer ICL generation with a central port for aqueous circulation. Classic Visian Toric ICL designs did not have this feature, so characteristics and procedural requirements depend on the exact model.
What astigmatism can a toric ICL correct?
The treatment range depends on the specific model and its regulatory labelling. In addition to cylinder magnitude, the clinician assesses stability and the nature of the astigmatism, as toric correction is primarily intended for predictable correction of regular astigmatism.
Who may be suitable for Visian ICL Toric?
It may be considered in adults with stable refraction and astigmatism, a clear natural crystalline lens and suitable ocular anatomy, particularly when corneal laser surgery is limited by refractive magnitude or corneal parameters.
Is there a strict age range for Visian ICL Toric?
There is no universal age range for every ICL generation. It depends on the specific model, regulatory labelling and natural lens status. Current US labelling for EVO/EVO+ Toric ICL covers ages 21–60, while local indications may differ.
How stable should refraction be before surgery?
Stability of both spherical and cylindrical refractive components is important before elective surgery. Continued change in myopia or astigmatism can result in residual refractive error after surgery. Exact criteria depend on the lens model.
Can Visian ICL Toric be used with a thin cornea?
A thin cornea does not automatically exclude a phakic lens. Because ICL implantation does not require corneal tissue removal, it may be considered when corneal parameters limit laser correction, provided anterior segment anatomy is suitable.
Is Visian ICL Toric suitable for irregular astigmatism or keratoconus?
Not automatically. A toric lens corrects a refractive component but does not treat ectasia or restore abnormal corneal shape. Keratoconus or irregular astigmatism requires corneal tomography, assessment of disease stability and an individualized strategy.
Is the natural crystalline lens removed?
No. This is a phakic lens, so the clear natural crystalline lens remains in place. This distinguishes the procedure from refractive lens exchange and cataract surgery.