The correction of astigmatism is a main component of refractive surgical interventions and over the past years has become an important part of cataract surgery. To improve outcomes in lens-based surgery, astigmatic manipulation has reduced the surgically induced astigmatism resulting from a larger wound (extracapsular cataract extraction, intracapsular cataract extraction) first with suture control and incision refinement, then with on-axis surgery and incision size reduction, and over the past 2 decades with inci-sional corneal procedures and toric intraocular lenses (IOLs). As the outcomes in refractive lens surgery with presbyopia-correcting IOLs is dependent on small amounts of postsurgical astigmatism, astigmatism measurement is necessary in every patient and correction is needed in at least 40% of patients.1 To correct the right amount of astigmatism in the appropriate axis, a precise presurgical measurement is necessary.
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