Can LASIK Fix Astigmatism? Everything You Need to Know

What is Astigmatism?

Astigmatism is a common vision condition where the cornea or lens of the eye has an irregular shape. Instead of being perfectly round like a basketball, the cornea or lens is more oval-shaped, similar to a football. This irregular shape prevents light from focusing properly on the retina, the light-sensitive surface at the back of the eye. As a result, vision becomes blurry or distorted at all distances.

Astigmatism can affect people of all ages. It can be present from birth or develop over time. The exact cause of astigmatism is still unknown, but genetics often play a role. If your parents have astigmatism, you are more likely to develop it too.

Astigmatism often occurs with other refractive errors, such as nearsightedness (myopia) and farsightedness (hyperopia). Nearsightedness makes distant objects appear blurry, while farsightedness causes close objects to be out of focus. Many people have a combination of these conditions, which can further complicate their vision issues.

Common Symptoms of Astigmatism

• Blurry or distorted vision
• Difficulty seeing at night
• Eye strain or discomfort
• Headaches
• Squinting to see clearly

For individuals wanting to gain a better understanding of their symptoms, try using the Docus Symptom Checker. Keep in mind that while online tools can offer valuable insights, they should not replace professional medical advice, diagnosis, or treatment. It's important to consult an eye care professional to discuss your symptoms and explore treatment options.

How Does LASIK Work?

What is LASIK?

LASIK (Laser-Assisted in Situ Keratomileusis) is a popular vision correction procedure designed to treat refractive errors, including astigmatism. This surgery reshapes the cornea to allow light to focus correctly on the retina, resulting in clearer vision. LASIK is known for its quick recovery time and effectiveness.

Technology Used in LASIK

The LASIK procedure employs two types of lasers: the femtosecond laser and the excimer laser. Each laser plays a crucial role in different stages of the surgery, ensuring precision and effectiveness.

• Femtosecond Laser: This laser is used to create a thin, circular flap in the cornea. It offers high accuracy and minimal risk, making the procedure safer and more reliable.
• Excimer Laser: Once the flap is created, the excimer laser reshapes the corneal tissue. This laser removes microscopic layers of tissue to correct the cornea’s shape, allowing light to focus correctly on the retina.

Steps Involved in the Surgery

Here's a step-by-step overview of how LASIK works:

1. Preparation: Before the surgery, numbing eye drops are applied to ensure you don't feel pain during the procedure. You will also receive a mild sedative to help you relax.
2. Creating the Flap: The surgeon uses the femtosecond laser to create a thin, circular flap in the cornea. This flap acts like a hinged door, allowing access to the underlying corneal tissue.
3. Reshaping the Cornea: Once the flap is lifted, the excimer laser is used to reshape the cornea. The excimer laser removes microscopic amounts of tissue to create a more regular curvature, which corrects the way light rays enter the eye.
4. Repositioning the Flap: After reshaping the cornea, the surgeon carefully repositions the corneal flap. The flap naturally adheres to the underlying corneal tissue without the need for stitches.
5. Recovery: The entire procedure typically takes about 30 minutes for both eyes. After the surgery, you will rest for a short period before going home. Your doctor will provide detailed post-operative care instructions to promote healing and minimize discomfort.

By following these steps, LASIK surgery effectively corrects vision, providing patients with a clearer and more precise sight. However, it’s crucial to follow the doctor’s guidelines during the recovery period to achieve the best possible results.

Can LASIK Fix Astigmatism?

LASIK is effective in treating astigmatism by reshaping the cornea to correct its irregular curvature. This allows light to focus properly on the retina, improving vision. LASIK is particularly successful for mild to moderate astigmatism, typically up to 6 diopters.

According to the Journal of Cataract and Refractive Surgery publication, more than 16 million LASIK surgeries have been performed globally with a high success rate, with 90.8% of patients achieving 20/20 vision or better and 99.5% achieving 20/40 vision or better. 

This demonstrates the procedure's high success rate and its potential to reduce or eliminate the need for glasses or contact lenses.

However, LASIK has its limits. It is less effective for severe astigmatism and may not fully correct vision in these cases. Some patients might still need corrective lenses for certain activities, even after the procedure.

Candidate Criteria for LASIK

The American Academy of Ophthalmology (AAO) has identified the ideal candidates for LASIK surgery, as well as those for whom it is not recommended:

Top Candidates for LASIK Surgery

To be considered for LASIK surgery, individuals should meet the following criteria:

• Age Requirement: Candidates should be at least 18 years old. Ideally, they should be over 21, when vision is more likely to have stabilized.
• Stable Prescription: Your eye prescription should have remained relatively unchanged for at least one year.
• Suitable Refractive Error: Your refractive error (nearsightedness, farsightedness, or astigmatism) should be within the treatable range for LASIK.
• Corneal Health: Your corneas must be thick enough and healthy. Overall eye health should also be good.

Not Recommended for LASIK Surgery

LASIK is not suitable for individuals with the following conditions:

• Unstable Refractive Error: Those with a changing prescription.
• Extreme Refractive Errors: Very high levels of myopia, hyperopia, or astigmatism.
• Severe Dry Eye: Individuals with significant dry eye conditions.
• Thin Corneas: Insufficient corneal thickness.
• Corneal Issues: Corneal scars, diseases, or keratoconus (cone-shaped cornea).
• Advanced Eye Conditions: Advanced glaucoma or a cataract affecting vision.
• Eye Infection History: A history of certain eye infections.
• Uncontrolled Diabetes: Poorly controlled diabetes.
• Pregnancy and Breastfeeding: Women who are pregnant or breastfeeding, due to potential vision changes during pregnancy.

By understanding these criteria, you can better assess whether LASIK is a viable option for you.

Benefits and Risks of LASIK

It's essential to have realistic expectations when considering LASIK. While many people achieve significant vision improvement, the procedure may not result in perfect vision for everyone.

Alternatives to LASIK for Astigmatism

For those who may not be suitable candidates for LASIK or prefer alternative treatments, several other surgical options are available:

PRK (Photorefractive Keratectomy):

• Pros: Suitable for patients with thin corneas; no corneal flap created.
• Cons: Longer recovery time compared to LASIK; initial discomfort post-surgery.

LASEK (Laser-Assisted Sub-Epithelial Keratectomy):

• Pros: Less invasive than LASIK; suitable for patients with thin corneas or dry eyes.
• Cons: Longer healing period; potential discomfort during recovery.

ReLEx SMILE (Small Incision Lenticule Extraction):

• Pros: Minimally invasive; small incision; quicker recovery time for some patients.
• Cons: Limited availability; may not be suitable for high levels of astigmatism.

Implantable Contact Lenses (ICL):

• Pros: Reversible procedure; suitable for high prescriptions; good for thin corneas.
• Cons: Higher cost; involves a more invasive procedure compared to LASIK.

Orthokeratology (Ortho-K):

• Pros: Ortho-K is non-surgical; involves wearing specially designed contact lenses overnight to reshape the cornea temporarily; suitable for those who are not ready for surgery or have mild to moderate astigmatism.
• Cons: Results are temporary and require continuous use of lenses; potential discomfort with lens wear; may not fully correct high levels of astigmatism.