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High corneal astigmatism is sometimes seen after Corneal graft surgery, and this can be corrected during the cataract IOL surgery. A very high astigmatism of 14 diopters was noted in this eye, and was corrected with a specially customised hydrophobic single piece IOL inserted during Cataract surgery. As the endothelial cells are compromised in such eyes, extreme care is taken during the entire procedure. The results were fabulous, with clear cornea from first post op day onwards, and the patient was very happy with her cataract, myopia as well as high astigmatism majorly corrected.