**8. Special cases**

Normally, cases with irregular astigmatism, corneal ectatic disorders, postrefractive surgery, post-keratoplasty, and high myopia are not ideal candidates for toric IOL implantation, partly because they are unlikely to achieve complete refractive correction with toric IOLs. However, the amount of astigmatism may be partly reduced, decreasing spectacle dependence. And such cases may be considered for surgery after adequate counseling. As a consequence, the applications of toric IOLs are expanding to include special cases such as pellucid marginal degeneration [74, 75], mild keratoconus with cataract [76], astigmatism after keratoplasty [77–80], and high astigmatism [81]; even toric trifocal IOLs were used in high astigmatism cases [82]. In general, the indications of toric IOL are still controversial and expanding.
