After more than 3 years of follow-up, the satisfactory results achieved with the toric iris-fixated phakic intraocular lens (IOL) mean we can regard implantation of this lens as a procedure with the potential to provide safe, predictable, effective and stable correction of astigmatic errors, providing patients are carefully selected and receive adequate preparation for surgery. The iris-fixated toric phakic IOL (Verisyse, Advanced Medical Optics; Artisan, Ophtec) is a PMMA lens with a total diameter of 8.5 mm and an optic diameter of 5 mm. It has a spherical anterior and a toric posterior surface. Its refractive power ranges from -2 dpt to -21 dpt for myopia and from +2 dpt to +12.5 dpt for the correction of hyperopia. Cylindrical correction is available from 2 dpt to 7.5 dpt. The Visian toric implantable Collamer lens (Staar) differs in that it is foldable and can be inserted through a very small incision of about 2.8 mm. It is placed in front of the natural lens in the ciliary sulcus. The aim of implanting these phakic IOLs is to correct the entire refractive error, meaning both the spherical and the astigmatic error, in a single step. Different lens models are available, and the selection depends on the direction of the cylinder axis and the anatomical situation, among other things.