Many individuals with astigmatism can undergo LASIK surgery. Advancements in laser technology have significantly expanded the treatable range of astigmatism, making it a common and successful procedure for correcting this refractive error. LASIK can often effectively address blurred or distorted vision caused by astigmatism, leading to improved clarity and reduced reliance on corrective lenses.
Understanding Astigmatism and LASIK’s Approach
Astigmatism is a common refractive error where the eye’s cornea, or sometimes the lens, has an irregular, oval shape instead of a perfectly round one, similar to a football. This irregular curvature causes light to focus on multiple points on the retina instead of a single, clear point, leading to blurred or distorted vision at all distances. Individuals with astigmatism may experience symptoms like blurred vision, squinting, headaches, or eye strain.
LASIK eye surgery corrects astigmatism by precisely reshaping the cornea using an excimer laser. After a thin, hinged flap is created on the corneal surface, the excimer laser removes microscopic amounts of tissue from the underlying cornea. This smooths the irregular curves, allowing light to focus properly onto the retina. The amount and pattern of tissue removal are customized for each patient based on detailed preoperative measurements, ensuring precise correction of the specific astigmatic error.
Eligibility Criteria and Considerations
Suitability for LASIK with astigmatism involves several factors. The degree of astigmatism is a primary consideration, with LASIK effective for regular astigmatism up to around 6.00 diopters. Patients with higher levels of astigmatism may still be candidates, but this is assessed individually.
A stable eye prescription, meaning no significant changes for at least one year, is another requirement. Fluctuating vision can affect the long-term stability of the LASIK outcome. Adequate corneal thickness is also necessary because LASIK involves removing corneal tissue to reshape the eye. The average corneal thickness ranges between 540 and 560 micrometers, and sufficient tissue must remain to maintain the eye’s structural integrity after the procedure.
Overall eye health plays a significant role in eligibility. Conditions such as severe dry eyes, glaucoma, cataracts, or active eye infections typically disqualify a candidate until managed or resolved. Uncontrolled autoimmune diseases or certain retinal conditions may also preclude LASIK. Candidates generally need to be at least 18 years old, as vision tends to stabilize in the early twenties. Temporary contraindications include pregnancy and nursing, as hormonal fluctuations can affect vision and healing.
Beyond LASIK: Other Vision Correction Options
For individuals with astigmatism not suitable for LASIK, several other effective vision correction options exist.
Photorefractive Keratectomy (PRK)
PRK uses an excimer laser to reshape the cornea without creating a flap. The outer layer of the cornea is gently removed before laser treatment, making PRK a viable option for those with thinner corneas or certain corneal conditions. PRK is effective for correcting astigmatism, often up to 4.0 diopters.
Small Incision Lenticule Extraction (SMILE)
SMILE is a minimally invasive laser procedure that corrects nearsightedness and astigmatism. A femtosecond laser creates a small, lens-shaped piece of corneal tissue (lenticule) within the cornea, which is then removed through a tiny incision. This reshapes the cornea without creating a large flap. SMILE is FDA-approved for astigmatism up to 3.00 diopters and offers advantages like faster healing and potentially less dry eye.
Implantable Collamer Lenses (ICLs)
ICLs offer another surgical alternative, particularly for individuals with higher prescriptions or severe dry eyes not good candidates for laser procedures. An ICL is a biocompatible lens surgically implanted behind the iris and in front of the natural lens. Toric ICLs are designed to correct astigmatism, providing clear vision without altering the corneal shape.
Non-surgical options like toric contact lenses and eyeglasses also remain widely available and effective for managing astigmatism.
Preparing for and Recovering from LASIK
Preparing for LASIK begins with a thorough pre-operative evaluation. This comprehensive eye exam assesses your overall eye health, measures corneal thickness and shape, and determines the stability of your prescription. You will also discuss your medical history, including any systemic conditions or medications, and review the potential risks and benefits. If you wear contact lenses, stop wearing them for a period before the evaluation to allow your cornea to return to its natural shape.
On the day of the procedure, arrive without eye makeup, creams, or fragrances, and arrange for transportation home as you will not be able to drive. Numbing eye drops will be applied for comfort, and a mild sedative may be offered to help you relax. The LASIK procedure is quick, usually taking only a few minutes per eye, during which you will focus on a light while the laser reshapes your cornea.
Immediately following LASIK, your vision may be hazy or blurry, and you might experience mild discomfort, burning, or itching. You will be given eye drops to prevent infection and promote healing, and protective shields to wear, especially while sleeping. It is important to avoid rubbing your eyes to prevent dislodging the corneal flap. Vision improves rapidly within the first few days, with most normal activities resuming quickly, though full vision stabilization can take three to six months. Regular follow-up appointments monitor your healing and vision progress.