To show how Custom and Made-to-Order Toric IOLs can be used effectively to restore high-quality vision in patients with stable corneal ectasias following cross-linking. After receiving informed consent, a custom-made toric IOL with high cylindrical power was implanted to correct the refractive defect in each eye, followed by clear lens extraction by phacoemulsification. Six months after surgery, the average power of the cylinder fell from 8.6 D to 0.75 D and the average power of the sphere from 2.95 D to 0.6 D. Patients with corneal ectasias with high cylinder post cross linking who were unable to tolerate CL or Glasses can be safely and efficiently fitted with high cylindrical power custom-made toric IOLs, improving their quality of life after surgery.