Can Cataract Surgery Fix Astigmatism?
There are several ways modern cataract surgery can correct astigmatism.
One option is to replace the eye's cloudy natural lens with a special type of premium intraocular lens (IOL) called a toric IOL.
A toric IOL works much like toric contact lenses for astigmatism. That is, it has different powers in different meridians of the lens to correct the unequal amount of nearsightedness or farsightedness in different parts of the eye that is characteristic of astigmatism.
If you have astigmatism, a toric IOL may reduce your need for eyeglasses after cataract surgery.
There is an advantage of using a toric IOL to correct astigmatism when a cataract is removed: Because the IOL is positioned securely inside the eye, it can provide a more stable correction of astigmatism than a toric contact lens, which moves on the surface of the eye with each blink.
For the greatest accuracy in the placement of a toric IOL, many cataract surgeons recommend laser cataract surgery. Due to the higher cost of a toric IOL and the added expense of using advanced laser technology, the cost of cataract surgery that includes astigmatism correction generally will be higher than that of a standard cataract surgery.
Another way to correct astigmatism during cataract surgery is called limbal relaxing incisions (LRI). In this procedure, one or more arc-shaped incisions are made near the periphery of the cornea. This gently reshapes the cornea into a more spherical shape, eliminating astigmatism.
If astigmatism is still a problem after cataract surgery, additional surgical procedures can be performed to reduce or eliminate it after your eye has fully recovered from your cataract procedure. These include: astigmatic keratotomy (AK), which is an LRI-like procedure performed with a surgical blade or a femtosecond laser, and LASIK.
About the Reviewer: Vance Thompson, MD, FACS, is the director of refractive surgery at Vance Thompson Vision in Sioux Falls, S.D. He also is professor of ophthalmology at the Sanford USD School of Medicine, a leading researcher in technologies for laser and implant vision correction and a member of All About Vision's editorial advisory board.
Page updated August 2017
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Toric IOLs for Astigmatism