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4 Astigmatism Surgery Options That You Should Know

By Nichole Tucker, MA
Get the facts on what eye surgery for astigmatism can involve, and understand the options your doctor might recommend.

Astigmatism is a common vision problem that can make things look blurry or distorted. You get this condition because the cornea or the lens of your eye isn’t evenly curved, the American Academy of Ophthalmology says. While astigmatism is often treated with glasses or contact lenses, your eye doctor might recommend surgery. 

“There are two main surgical options for patients with astigmatism: cornea-based or lens-based surgery,” Tommy CY Chan, MD, an ophthalmology specialist at the Hong Kong Sanatorium & Hospital, tells WebMD Connect to Care.  

Your cornea is the clear, front surface of your eye. Some cornea-based surgeries that can treat astigmatism are:

Photorefractive keratectomy (PRK). An eye surgeon removes the outer layer of cells on your cornea, and then reshapes the cornea with a laser, the American Academy of Ophthalmology says. PRK might be an option for you if you have dry eyes or thin corneas.

Laser-assisted in-situ keratomileusis ( LASIK). An eye surgeon reshapes your cornea through a thin flap they make on its surface, the American Academy of Ophthalmology says. LASIK may be an option for you if your doctor says that your corneas are thick enough. 

Small incision lenticule extraction (SMILE). The surgeon uses a laser to sculpt a disc-shaped piece of your cornea below the surface of your eye. Then they remove the disc through a small, laser-made incision in your cornea, the American Academy of Ophthalmology says. SMILE may be an option for you if you have mild nearsightedness and astigmatism.

Lens-based surgery for astigmatism is more invasive, because it’s done inside your eye, according to the American Academy of Ophthalmology. One lens-based option is:

Astigmatism correction along with cataract surgery.This method is commonly used for elderly people with astigmatism who also have a cloudy area, or cataract, in the lens of their eye. 

For caract surgery, your eye doctor removes your cloudy lens and replaces it with an artificial lens, the National Eye Institute says. The doctor can fix your astigmatism during this surgery either by implanting a special astigmatism-correcting lens called a “toric intraocular lens," a light adjustable lens (the latest lens technology using UV light to adjust the focusing power after cataract surgery) or by making small but deep cuts in the cornea (called “limbal relaxing incisions”), the American Academy of Ophthalmology says. Or, your doctor can correct your astigmatism with LASIK or PRK after cataract surgery, the academy says.

If your eye doctor recommends that you get astigmatism surgery, ask them which types of surgery would be right for you. To narrow down your options, they’ll consider things like your general eye health and whether or not you have a less-common type of astigmatism called irregular astigmatism, which is tied to problems with your cornea.

Remember: Any type of surgery involves risks, so be sure to ask your eye doctor about possible side effects and complications, too. 

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