Yes you can still have a Visian ICL if you have astigmatism. While the toric Visian ICL, which is specifically designed to correct astigmatism, is not available in the US, we can typically correct the astigmatism when ICLs are implanted in one of 3 ways. The first and most frequent method is to place the incision to insert the Visian ICL in a such a way as to decrease the astigmatism. The next way is to make small incisions in the cornea to relax, or reduce the astigmatism, either at the time of surgery or later. In cases with more significant astigmatism, we typically do LASIK to eliminate the astigmatism. LASIK is very accurate in correcting astigmatism, depending on which Laser is being used. In my opinion large amounts of astigmatism are accurately corrected with the Wavelight or Allegretto laser, and less so with the others, at least in my experience.