When you have astigmatism, the world can seem blurred and fuzzy. LASIK surgery is designed to permanently remove tissue from your eye, which can help to mitigate the vision problems astigmatism can cause. (Learn more) In other words, yes - LASIK absolutely can correct or "fix" astigmatism.
While LASIK can be very successful in treating astigmatism, it works best for people with certain types of astigmatism, and it's best when performed in a certain way. (Learn more) If LASIK isn't right for you, there are many other ways to treat astigmatism. (Learn more)
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Understand How LASIK Is Performed
The term LASIK stands for laser-assisted in-situ keratomileusis. This is a form of eye surgery that makes permanent adjustments to your eye. It is performed by surgeons using complicated machinery, and the surgery takes just minutes to complete.
During LASIK surgery, your doctor makes a small flap within the cornea of your eye. That flap is folded back, giving your doctor access to more corneal tissue. A laser is used to remove some of that tissue based on measurements taken before your surgery. When the proper amount of tissue is gone, your doctor folds the flap back down. The flap works a little like a bandage on the healing tissue below.
These basic LASIK surgery steps are used to correct many types of vision problems, including astigmatism as well as nearsightedness and farsightedness. The surgery itself does not change based on diagnosis. Only the amount and placement of the tissue change based on your vision issue.
The American Refractive Surgery Council reports that more than 19 million LASIK surgeries have been performed within the United States. Should you choose to have surgery for your astigmatism, you will certainly not be alone.
Astigmatism is caused by an irregular eye shape, and often, that irregularity involves the cornea. Since LASIK is a surgery performed on the cornea, it seems like an ideal solution to astigmatism troubles. And for many people, the surgery is transformative.
LASIK Can Be Very Successful
When you have astigmatism, the irregular shape of the eye causes images to come into focus either in front of or behind the retina. To correct that issue, doctors can use lenses to bend the light before it hits your eye. Those lenses can allow the images to focus on the proper part of the eye, leading to clear vision.
Doctors can use glasses or contact lenses to provide that bending of light. These solutions can be uncomfortable for some people, however. As Optometry Australia points out, these lenses can distort the appearance of items in your visual field. Walls can seem curved or sloped, as can floors. You may think items are bigger or smaller than they should be. Some people adjust to these distortions, but some do not.
The Federal Trade Commission reports that many people are pleased with the results of LASIK. According to research cited by them, 9 in 10 patients achieve 20/20 to 20/40 vision after LASIK.
This means at least some people who have LASIK need to use glasses or contacts at least some of the time in order to see things clearly. But it also indicates that most people who have surgery see some kind of visual benefit from the procedure.
Because LASIK involves removing eye tissue, doctors are careful to offer the procedure only to people with an optimal prescription. People with very significant prescriptions may not have enough eye tissue left behind when the laser is done removing tissue.
The National Institute for Health and Care Excellence in the UK reports that LASIK can be used in people with a prescription of up to four cylinders of astigmatism. This is a measurement your doctor will take, and if your prescription is beyond this level, the surgery might not be safe for you. If you have another eye issue, such as nearsightedness or farsightedness, similar measurements and checks will be taken. If your prescription is too strong for either of these issues, surgery might also not be right for you.
If you're dealing with only a small amount of astigmatism, LASIK might similarly be less than ideal for you. In a study in the Journal of Cataract and Refractive Surgery, researchers found that people with astigmatism levels measured at 0.5 diopter saw no real benefit from LASIK surgery. That means the risks they faced from having surgery were simply larger than the tiny benefit they might achieve from having their eyes cut and worked on. If your prescription is too small, your doctor may tell you the same.
The space in which your irregular shape is located can also matter in terms of how well the surgery works for you. In research cited by the Journal of Cataract and Refractive Surgery, the data suggests that people with astigmatism located on the anterior portion of the cornea fared better with LASIK than people with astigmatism located on the posterior portion of the cornea.
This makes intuitive sense. Since LASIK operates on the anterior portion of the cornea, it is logical that the surgery would be most effective in people with a curve on the anterior. But it's another indication that efficacy rates can vary from person to person with astigmatism based on the unique health and shape of their eyes.
The equipment your doctor uses can also play a role in the efficacy of LASIK in correcting astigmatism. Advanced machines come with mapping capabilities that can help your doctor to map the tissue removal very minutely, which could be important in addressing astigmatism. Advanced machines can also use a laser to make the incision, which can allow for smaller cuts and quicker healing.
Other Ways to Treat Astigmatism
While LASIK can be helpful in treating astigmatism, it isn't the right solution for all people. Your doctor may say the surgery isn't right for you if:
- Your corneas are thin.
- Your prescription is too strong.
- You have an autoimmune disorder.
- Your eyes are always dry.
- You have a health condition that impedes healing, such as diabetes.
LASIK also comes with some risks, including undercorrection. When that happens, you may still struggle to see clearly when the surgery is complete. You may also find that you cannot see as clearly after surgery as you did when you wore glasses or contacts before surgery. Some people struggle with dry eyes or halos after surgery too.
These complications may be rare, but they could keep you away from scheduling surgery. Some people may be leery of accepting a surgery when there are other options available.
According to research published in Europe PMC, LASIK with an excimer laser is considered the best surgical technique for astigmatism correction. There are other surgeries available, but they may not stack up to the benefits of LASIK with this type of machine.
According to the National Eye Institute, wearing eyeglasses is the safest and easiest way to correct astigmatism. Glasses do cause some visual disturbances, but you may be able to adjust to those issues. Glasses are also typically covered by insurance, which is not true of LASIK.
We Can Help You
We know that LASIK can help people with astigmatism. But we also know that LASIK is a permanent procedure, and you will want to consider your options carefully. That's why we begin all of our consultations with an examination. We look at your eyes, we check your prescription, we discuss your lifestyle, and we help you understand whether or not surgery is right for you.
If you decide that surgery is not right for you, we can help you understand your other options. Please contact us to set up an appointment.
How Does LASIK Work? Everything You Need to Know About LASIK Eye Surgery. (June 2017). American Refractive Surgery Council.
Your Eye Health: Astigmatism. Optometry Australia.
The Basics of LASIK Eye Surgery. Federal Trade Commission.
Photorefractive (Laser) Surgery for the Correction of Refractive Errors. (March 2006). National Institute for Health and Care Excellence.
Minimum Amount of Astigmatism That Should Be Corrected. (January 2014). Journal of Cataract and Refractive Surgery.
Efficacy of Laser In Situ Keratomileusis in Correcting Anterior and Non-Anterior Corneal Astigmatism: Comparative Study. (October 2010). Journal of Cataract and Refractive Surgery.
Astigmatism Correction With Excimer Laser. (March 2012). Europe PMC.
Facts About Astigmatism. (October 2010). National Eye Institute.