Laser Eye Surgery for Astigmatism
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Laser Eye Surgery for Astigmatism – A Guide

Have you ever wondered why your vision seems blurry or distorted, even when wearing your glasses or contact lenses? You could be dealing with a common eye condition known as astigmatism.

This condition can lead to symptoms like blurry vision and eye strain, but the good news is that it’s treatable, and one of the most effective treatments is laser eye surgery for astigmatism.

But what exactly is astigmatism, and how does laser eye surgery help? Let’s dive into these questions and more.

Key Takeaways

LASIK for AstigmatismHighly effective, suitable for various degrees of astigmatism, quick recovery.
LASEK for AstigmatismGood for patients with thin corneas, effective for mild to moderate astigmatism, longer recovery.
SMILE for AstigmatismMinimally invasive, suitable for active lifestyles, quick recovery, less initial dry eye symptoms but same as LASIK later.
ICLsReversible, preserves corneal structure, ideal for high degrees of astigmatism.
RLELong-term solution, prevents cataracts, suitable for presbyopia or significant refractive errors.
Glasses & Contact LensesNon-surgical, convenient, flexible, and cost-effective for correcting astigmatism.

Understanding Astigmatism

An illustration of distorted vision

Astigmatism, an eye condition, occurs when the cornea or lens isn’t perfectly round, leading to blurred vision at all distances. The irregularity can be likened to the shape of a rugby ball, as opposed to a spherical football, resulting in blurred or distorted vision. If you’ve been dealing with these symptoms, you may have astigmatism.

Astigmatism is the most common refractive error ( a focusing problem needing glasses) but it often comes together with short-sightedness, long-sightedness or presbyopia (the need for reading glasses).

Common treatments for astigmatism include:

  • eyeglasses

  • contact lenses

  • refractive surgery, such as laser vision correction

Laser eye surgery reshapes the cornea to rectify the irregular curvature responsible for astigmatism. But what causes astigmatism in the first place?

Causes of Astigmatism

The primary cause of astigmatism is an uneven curvature across the cornea, leading to irregular light focusing on the retina and subsequent blur or distortion.

Around one third of people have significant astigmatism, while another third have mild astigmatism.

Certain conditions, like keratoconus, which causes cornea thinning, can also lead to astigmatism.

The extent of astigmatism is quantified in dioptres and may be either positive (+) or negative (-).

Symptoms of Astigmatism

But how would you know if you have astigmatism? Typical symptoms include:

  • Blurry vision

  • Eye strain

  • Headaches

  • Distorted images

  • Squinting frequently

  • Heightened glare around lights

  • Appearance of halos or streaks around light sources

Astigmatism can significantly impact night vision.

Should these symptoms be familiar, a routine eye examination by an optometrist is necessary to diagnose astigmatism. But how does astigmatism affect your eyesight?

Effects on Sight

The abnormal curvature of the eye in astigmatism results in light focusing on several points on the retina instead of a single sharp point, thus affecting vision. As a result, you may experience blurred or wavy vision and perceive distorted shapes and colours, which can contribute to overall eyestrain.

Astigmatism can also lead to:

  • impaired nighttime visual acuity, characterized by blurred vision

  • heightened glare around lights

  • the perception of halos or streaks around light sources

The good news is that several laser eye surgery options are available to correct astigmatism, including the popular LASIK eye surgery.

Laser Eye Surgery Options for Astigmatism

Photo of a laser eye surgery procedure

Laser eye surgery, a type of laser surgery, revolutionizes the treatment of astigmatism. The primary categories of laser eye surgery include LASIK, SMILE, and surface laser treatments such as PRK/LASEK.

These procedures involve reshaping the cornea using a laser, leading to a more spherical cornea and the accurate focusing of light onto the retina.

With a success rate of 100% for typical shortsighted patients with up to 2.00 dioptres of astigmatism, LASIK is widely regarded as the preferred treatment for astigmatism. But let’s break down these procedures a bit further.


LASIK, or Laser-Assisted In Situ Keratomileusis, is the most common form of refractive surgery for astigmatism. During the procedure, the surgeon creates a precise flap in the cornea and uses a laser to remove ultra-thin layers, reshaping the corneal surface. This corrects the irregular curvature that causes astigmatism.

The procedure typically lasts approximately 5 minutes per eye.

The vision recovery is the fastest of any laser eye surgery procedure. People can usually see fairly well on first sitting up, although with a mild blur. Excellent vision is achieved within 4-8 hours for most patients.

Final recovery time is between three to six months, subject to individual circumstances. But what if LASIK isn’t the right fit for you?


Photorefractive Keratectomy (PRK) or Laser-Assisted Subepithelial Keratectomy (LASEK) are surface laser treatments that are alternatives to LASIK. These procedures involve using a laser to reshape the irregular curvature of the cornea, thereby enhancing the way light is directed onto the retina.

While PRK/LASEK may entail a slightly elevated risk of infection compared to LASIK, they share similar side effects, including blurry vision and discomfort.

The main downside of surface laser treatments is the post-operative pain, lasting 2-3 days. Also, the sight takes 4-7 days to be reasonably clear, and continues to improve week on week and has caught up to LASIK around three months after treatment.

Another alternative is the SMILE procedure.


SMILE, or Small Incision Lenticule Extraction, is a form of laser eye surgery used to treat astigmatism. SMILE is actually a brand name, and others include SILK, CLEAR and SmartSight. The correct name for this kind of procedure is lenticule extraction.

The procedure involves:

  1. The application of anaesthetic eye drops

  2. Utilisation of a femtosecond laser to form a lenticule

  3. Creation of a small incision in the cornea

  4. Extraction of the lenticule

  5. The natural closure of the incision without the need for sutures

SMILE is a suitable procedure for mild nearsightedness combined with astigmatism.

Now that we’ve explored the various laser eye surgery options let’s discuss who can be a candidate for these procedures with a laser eye surgeon.

Candidacy for Laser Eye Surgery

Laser eye surgery isn’t suitable for all astigmatism patients. Eligibility depends on meeting certain criteria like:

  • Age

  • Prescription stability

  • Corneal thickness

  • Absence of specific medical conditions

We’ll examine each of these factors in more detail.

Age and Prescription Stability

When it comes to laser eye surgery, age matters. The minimum age requirement for the surgery is 18 years old due to the ongoing development and eye changes during adolescence.

Moreover, ensuring prescription stability before the procedure is paramount and this may not happen until after the age of 20. A prescription should remain stable for at least one year before considering laser eye surgery.

Corneal Thickness

The thickness of your corneal tissue significantly determines the most appropriate type of laser eye surgery. If you have thin corneas, you may need to consider alternative treatments. Corneal thickness is measured through pachymetry, a straightforward and painless test that rapidly measures the cornea’s thickness.

Lastly, let’s discuss how certain medical problems can affect your candidacy for laser eye surgery.

Medical Conditions

Certain medical issues may prevent patients from undergoing laser eye surgery, including:

  • Pregnancy

  • Breastfeeding

  • Autoimmune disorders

  • Corneal dystrophy

  • Eye herpes infection

  • Glaucoma

Booking a consultation with a qualified eye surgeon to assess your suitability for the procedure is vital.

Now that we better understand who can undergo laser eye surgery let’s discuss the risks and benefits involved.

Risks and Benefits of Laser Eye Surgery for Astigmatism

As with any surgical procedure, potential risks and benefits accompany laser vision correction for astigmatism. Understanding these can help you make an informed decision about whether the procedure is right for you.


The most common side effect is dry eyes, lasting 3-6 months after treatment. Additional treatment, known as an enhancement, may be required if a small prescription remains (1-2% of cases). Other potential side effects include glare, halos, and difficulty seeing in low light conditions

A rarer side-effect is night-time glare, haloes or starbursts. This is more common in those with very large pupils in the dark, or when astigmatism is present with a very large degree of short-sight or long-sight.

Complications leading to severe sight loss are exceptionally rare but can happen due to severe eye infections that result in corneal scarring and an irregular corneal surface.


Conversely, laser eye surgery offers numerous benefits, including:

  • Significantly enhancing vision

  • Reducing the reliance on corrective eyewear

  • Rectifying the irregular corneal shape, resulting in improved vision without the necessity of glasses or contact lenses

  • Having a high efficacy rate for treating astigmatism and enhancing patients’ vision

However, if laser eye surgery isn’t suitable for you, there are alternatives.

Alternatives to Laser Eye Surgery for Astigmatism

Photo of toric contact lenses

If laser eye surgery doesn’t suit you, other corrective options for astigmatism are available, such as toric contact lenses and refractive lens exchange. Both of these options can significantly improve vision for those with astigmatism.

Toric Contact Lenses

Toric contact lenses are specially designed to correct astigmatism by offsetting the irregular shape of the cornea or lens. They are crafted from either toric hydrogel or toric silicone hydrogel materials. Several brands provide toric contact lenses, including:

  • Acuvue

  • Focus Dailies

  • Biofinity

The lenses should be replaced according to the recommended wearing schedule, which may be daily, weekly, every two weeks, or monthly, depending on the lens type.

Implantable Contact Lenses (ICL)

Implantable contact lenses (ICL) are revolutionary for correcting astigmatism. This advanced procedure is an excellent alternative for those who may not be suitable candidates for laser eye surgeries such as LASIK or PRK.

The ICL method involves the insertion of a small, biocompatible lens, similar to a soft contact lens, into the eye. This lens is placed behind the iris and in front of the natural lens. By positioning it here, the ICL can reshape light entering the eye, effectively correcting astigmatism and improving visual acuity.

One of the main advantages of ICL over traditional corrective procedures is that it’s reversible.

Unlike laser treatments that permanently alter the cornea’s shape, your surgeon can easily remove or replace the implanted lens if any changes occur in your vision or new advancements in optical correction.

Furthermore, ICL offers immediate results, with most patients reporting dramatic improvements in their vision within 24 hours post-surgery. The recovery period is also minimal as no stitches are required due to the tiny incision made during surgery.

However, like all surgical procedures, there are potential risks involved with ICL, including infection and cataract formation. Therefore, it’s vital to have a comprehensive discussion with your ophthalmologist about these risks and whether this solution aligns with your lifestyle needs and expectations.

ICLs provide an innovative solution for astigmatism correction, offering visual results and flexibility.

Refractive Lens Exchange

Refractive Lens Exchange (RLE), also known as lens replacement surgery or lens exchange surgery, involves the removal of the eye’s natural lens and the placement of a new artificial lens (IOL) in its position.

This procedure is usually recommended for individuals above the age of 45-50. The surgery involves using a local anaesthetic and lasts approximately 15 minutes per eye.

Now, let’s discuss how to prepare for and recover from laser eye surgery.

Preparing for and Recovering from Laser Eye Surgery

Illustration of pre-operative and post-operative care for laser eye surgery

Whether you choose laser eye surgery or an alternative treatment, adequate pre-operative and post-operative care is vital for successful results. We’ll delve into the preparation process for surgery and the expected recovery journey.

Pre-Operative Care

Before undergoing laser eye surgery, you’ll need to prepare for a pre-operative discussion with your surgeon. This includes:

  • Removing all eye makeup at least 24 hours before the surgery

  • Maintaining a makeup-free face and eyes on the day of the discussion

  • Being prepared for a comprehensive pre-operative examination

  • Following all pre-operative instructions provided by the surgeon.

Post-Operative Care

After surgery, you must attend follow-up appointments to facilitate proper healing and achieve optimal visual outcomes. You’ll also be prescribed eye drops to prevent infection and reduce inflammation.

The full recovery process can take three to six months, with most of the healing taking place within the first day.

Now, let’s wrap things up.


Astigmatism, a common eye condition, can cause blurry or distorted images in your vision. However, treatments like laser eye surgery can correct this issue and restore clear vision.

Whether you choose LASIK, PRK/LASEK, SMILE, or even an alternative like toric contact lenses or refractive lens exchange, options are available.

Consult with your eye care professional to determine the best fit for your needs.

Frequently Asked Questions

Can astigmatism be cured with laser eye surgery?

Yes, laser eye surgery is an effective solution for treating astigmatism. It reshapes the eye’s cornea to improve focus and correct short-sightedness, long-sightedness and astigmatism.

Is LASIK worth it for astigmatism?

Yes, LASIK is generally worth it for astigmatism sufferers. Most people experience improved vision without glasses or contacts after the procedure.

What is the success rate of LASIK surgery for astigmatism?

LASIK surgery for astigmatism has an impressive success rate, typically reaching up to 99% for 20/40 vision and 90% for 20/20 vision.

Is laser eye surgery more expensive with astigmatism?

Laser eye surgery for astigmatism usually costs more than average and requires specialist treatment. Prices range from £2,400 to £2,800 per eye, depending on the procedure and surgeon’s experience.

What is astigmatism?

Astigmatism is a vision condition caused by an irregularly shaped cornea or lens, which results in blurred or distorted vision.

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