Last Updated: 29 April, 2025
Astigmatism, a refractive error that causes blurry or distorted vision, is a common condition experienced by people of all ages. For years, glasses and contact lenses were the primary solutions for managing astigmatism. However, advancements in medical technology have introduced laser eye surgery as a permanent, effective treatment.
But how does it work, and is it suitable for everyone? Let us dive into the details.
Understanding astigmatism
Astigmatism occurs when the eye’s cornea or lens has an irregular shape, preventing light from focusing evenly on the retina. In a healthy eye, the cornea is shaped more like a sphere, but in an eye with astigmatism, it resembles more of a football. This irregularity causes:
- Blurry or distorted vision.
- Difficulty focusing on objects at any distance.
- Headaches, eye strain, and discomfort during prolonged visual tasks.
Astigmatism often occurs in conjunction with nearsightedness (myopia) or farsightedness (hyperopia).
How laser eye surgery corrects astigmatism?
Laser eye surgery works by reshaping the cornea to correct its irregular curvature, allowing light to focus correctly on the retina. This correction provides clear and sharp vision.
Types of laser eye surgery for astigmatism
There are three main types of laser eye surgery used to treat astigmatism:
1. LASIK (Laser-Assisted In Situ Keratomileusis)
- Procedure:
- A thin flap is created on the cornea using a microkeratome or femtosecond laser.
- The underlying corneal tissue is reshaped using an excimer laser to correct the irregularities.
- The flap is repositioned and acts as a natural bandage.
- Advantages:
- Fast recovery: Most patients experience improved vision within 24-48 hours.
- Minimal discomfort: The procedure is quick, with minimal pain during and after surgery.
- Effectiveness:
- LASIK is ideal for mild to moderate astigmatism and is known for its high success rates.
2. PRK (Photorefractive Keratectomy)
- Procedure:
- The outer layer of the cornea (epithelium) may be removed.
- The excimer laser reshapes the cornea to correct astigmatism.
- A bandage contact lens is placed to protect the eye during healing.
- Advantages:
- Suitable for patients with thinner corneas.
- No flap creation, reducing the risk of complications related to the flap.
- Effectiveness:
- PRK is effective for mild to moderate astigmatism, but recovery takes slightly longer than LASIK.
3. SMILE (Small Incision Lenticule Extraction)
- Procedure:
- A femtosecond laser creates a small lens-shaped piece of tissue (lenticule) within the cornea.
- The lenticule is removed through a tiny incision, reshaping the cornea.
- Advantages:
- Minimally invasive: No corneal flap is created.
- Faster healing with fewer complications.
- Effectiveness:
- SMILE is ideal for moderate to high astigmatism and offers excellent results.
Who is a good candidate for laser eye surgery?
Laser eye surgery is not suitable for everyone. You may be a good candidate if you:
- Are over 18 years old and have stable vision for at least a year.
- Have healthy eyes with no active infections or significant conditions like keratoconus.
- Have mild to moderate astigmatism.
- Are not pregnant or nursing, as hormonal changes can affect vision.
- Have realistic expectations about the outcomes of surgery.
Benefits of laser eye surgery for astigmatism
- Permanent correction: Laser surgery provides a long-lasting solution, reducing or eliminating the need for glasses or contact lenses.
- High success rates: Most patients achieve 6/6 (20/20) vision or better after surgery.
- Quick procedure: The surgery typically takes 15-30 minutes for both eyes.
- Rapid recovery: Many patients experience improved vision within a few days.
- Freedom from Glasses and Contacts: Enjoy daily activities without the hassle of corrective lenses.
- Improved quality of life: Clear vision enhances confidence and productivity.
Risks and Limitations of laser eye surgery
While laser eye surgery is generally safe, it is essential to understand the potential risks and limitations:
- Dry eyes: Dry eye is common after surgery, and often temporary, but can require long term artificial tear drops.
- Halos or Glare: Some patients may notice halos or glare around lights, especially at night.
- Undercorrection or Overcorrection: In some cases, the laser correction may not achieve the perfect outcome, requiring additional surgery.
- Not suitable for severe astigmatism: Patients with extreme astigmatism may require alternative treatments like toric intraocular lenses.
What to expect during the procedure ?
- Consultation: A thorough eye examination will determine if you are a suitable candidate for laser eye surgery.
- Surgery day: The procedure is painless, thanks to numbing eye drops. You will be awake during the surgery, and it takes less than 30 minutes.
- Post-surgery care: You will need someone to drive you home. Rest and follow the prescribed care routine to ensure a smooth recovery.
Recovery timeline
- First 24 hours: Avoid rubbing your eyes and follow your doctor’s instructions. Some discomfort and blurry vision are normal.
- First week: Vision stabilises, but avoid strenuous activities or exposure to water.
- One month: Most patients achieve optimal vision by this time. Regular follow-ups ensure proper healing.
Conclusion
Laser eye surgery has transformed the treatment of astigmatism, offering a life-changing alternative to glasses or contact lenses. By utilising advanced technology, this procedure delivers precise and lasting results, significantly enhancing vision and quality of life. It is a safe, effective, and efficient option for individuals seeking freedom from visual impairments caused by astigmatism.
Author bio
Dr Parth Shah is a leading ophthalmologist in Canberra. With extensive training and experience, he is renowned for his expertise in the field. Dr Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He is a true advocate for eye health and a trusted name in the Canberra ophthalmology community.
FAQs
Yes, laser eye surgery can correct astigmatism along with other refractive errors such as nearsightedness (myopia) and farsightedness (hyperopia). The laser reshapes the cornea to address all these issues in a single procedure.
The results of laser eye surgery are generally permanent. However, natural age-related changes in vision, such as presbyopia or cataracts, may still develop over time and affect overall vision.
Yes, in some cases, laser eye surgery can be repeated or enhanced if the initial results are not fully effective or if vision changes over time. However, this depends on factors like corneal thickness and overall eye health.
If you are not a candidate for laser eye surgery, options include:
- Toric contact lenses designed specifically for astigmatism.
- Glasses with corrective lenses.
- Implantable collamer lenses (ICL).
- Refractive lens exchange (RLE).
The cost of laser eye surgery varies depending on the type of procedure, surgeon expertise, and location. Most insurance plans do not cover laser vision correction.
People with dry eye syndrome may still be eligible for laser eye surgery, but the condition must be managed beforehand. Pre-surgery treatment may include artificial tears, prescription eye drops, or punctal plugs to stabilise the tear film.
Before surgery:
- Avoid wearing contact lenses for a few weeks, as they can alter the shape of your cornea.
- Disclose your medical history and current medications to your doctor.
- Follow any pre-surgery instructions given, such as avoiding makeup or eye creams on the day of surgery.
Laser eye surgery offers a permanent solution, providing clear vision without the need for daily maintenance. Toric lenses and glasses, while effective, are temporary solutions requiring regular adjustments or replacements. Surgery also eliminates discomfort associated with wearing lenses or glasses.
