Eye surgery for astigmatism
While glasses, contact lenses and orthokeratology (Ortho-k) can temporarily treat the effects of astigmatism, surgery is the only way to permanently correct it. Laser eye surgery and, in some cases, implantable toric lenses, can be used for permanent astigmatism correction.
The type and extent of astigmatism, corneal thickness, age and other eye conditions should be considered when deciding whether surgery is a good option — and if so, which type of surgery.
Laser surgeries that can correct astigmatism by changing the shape of the cornea include:
LASIK: A small flap is made in the upper layers of the cornea (epithelium) and then folded back to allow the laser to reshape the tissue underneath.
LASEK: As opposed to creating a flap, the epithelium is loosened with a special solution and moved to the side to provide access the corneal tissue.
Epi-LASIK: While similar to LASEK, in this procedure, the epithelium is loosened and shifted with a blunt surgical tool.
PRK: The epithelium is removed altogether to access the corneal tissue before quickly growing back.
SMILE: A precisely cut piece of tissue is removed from the cornea through a microscopic incision, leaving the epithelium intact.
Options for those ineligible for laser surgery include:
Cataract surgery with a toric lens replacement: The natural lens isI replaced with a toric lens to correct astigmatism during cataract surgery.
Refractive lens exchange: Also during cataract surgery, but as a refractive error correction instead of for cataracts
Lens implants: Permanently places contact lenses inside the eye over or behind the iris while the natural lens stays in place.
Due to their significantly more invasive nature, lens implants and lens exchanges are recommended far less often for people who can achieve clear vision with glasses or contacts or who qualify for laser surgery.
LASIK for astigmatism
Many people with astigmatism qualify for one of two forms of laser surgery: LASIK or PRK. LASIK is the most common procedure used to correct astigmatism and its symptoms.
Astigmatism occurs when the front of the eye (cornea) is misshapen, causing light to focus incorrectly inside the eye. The goal of LASIK is to change the shape of the cornea so light focuses as it should on the back of the eye (retina).
During LASIK eye surgery, a small flap of tissue is created on the eye to allow a surgeon access to the cornea. The flap can be created with a small blade or laser, depending on the procedure.
Once the flap has been lifted, the surgeon focuses an ultra-precise laser on the cornea and slowly reshapes it based on previous eye measurements. The laser is designed to automatically shut off if you move your eye.
Once surgery and recovery are complete, patients usually report clear or greatly improved vision.
Side effects of LASIK for astigmatism
Some side effects are common and most disappear within a few weeks to a few months. These can include:
Glare and light sensitivity
Visual halos or starbursts
Night vision problems
Continued need for glasses, contact lenses or additional treatment
While LASIK is generally regarded as a safe procedure, rare complications can occur. They can include:
Problems with the corneal flap healing
Vision reverting back to its original state
Rarely, varying levels of vision loss
SEE RELATED: Astigmatism FAQs
PRK for astigmatism
People who don’t qualify for LASIK may still be eligible for PRK surgery. LASIK removes tissue from the inner layer of the cornea, while PRK removes tissue from both inner and outer layers.
Recovery from PRK takes longer and involves more precautions than LASIK, but PRK is considered easier, faster and cheaper than LASIK.
Like LASIK, PRK is widely recognized as a safe procedure. But it too can lead to side effects or rare complications, which are generally the same as those resulting from LASIK.
How much do LASIK and PRK cost for astigmatism?
In 2019, the average cost of LASIK in the United States was $2,246 per eye, according to a report prepared for All About Vision by market research firm Market Scope. Pricing can vary depending on the surgeon’s experience and technology used during surgery.
On average, PRK generally costs the same or slightly less than LASIK.
LASIK and PRK are considered elective procedures, so they aren’t usually covered by vision or medical insurance. Patients sometimes use flexible spending accounts (FSA) or financing options to cover all or a portion of the expense of vision surgery.
HOW MUCH CAN YOU EXPECT TO PAY FOR LASIK OR PRK? Find an eye doctor near you and schedule a consultation for complete pricing information.
Cataract surgery and astigmatism
During cataract surgery, a surgeon replaces the clouded lens inside the eye (cataract) with a lens implant, called an intraocular lens (IOL). A patient with astigmatism can choose to have a slightly different lens implanted during surgery — a toric IOL.
A toric IOL can greatly improve the effects of both cataracts and astigmatism in one procedure.
Talk to an eye doctor or surgeon
The best way to find out if you qualify for astigmatism surgery is by scheduling an appointment with an eye doctor. They can help you identify your type of astigmatism and decide if and what kind of surgery may be right for you.
Page updated January 2021