Can I Have LASIK If I Have Astigmatism?

LASIK
ADAM

Question: Can I have LASIK if I have astigmatism?

Answer:

If you have astigmatism, you may be able to have LASIK eye surgery. LASIK is a type of refractive surgery used for correcting refractive errors such as astigmatism, myopia, and hyperopia. If you have astigmatism, your vision may be blurry at a distance as well as near. You may feel tired after reading and find that letters and words appear to be slanted.

Many people with astigmatism have found LASIK eye surgery to be a safe and effective method of vision correction.

For some reason, there is a "stigma" about astigmatism when it comes to LASIK. However, most patients with astigmatism can have laser refractive surgery. Most of this stems from the fact that is was the first type of vision problem approved by the FDA for LASIK.

What is astigmatism?

Astigmatism is often misunderstood. People have astigmatism, not a stigmatism. It is a vision problem usually caused by the cornea, the clear dome-like structure on the front part of the eye, having a shape similar to a football, rather than a basket ball. So, there is more power or more curvature in one meridian, for example at 90 degrees, than there is at the opposite meridian at 180 degrees. While the majority of astigmatism is most often corneal astigmatism, one can also have lenticular astigmatism.

The cornea may be perfectly round or spherical, but the lens inside the eye has astigmatic power. 

How is astigmatism measured?

Astigmatism is measured with a corneal topographer. A corneal topographer is a machine that projects a disc of lights onto the cornea. Data that is reflective back shows the curvature over the entire cornea which is used to calculate the amount and direction of astigmatism.

The amount of power that is needed to correct astigmatism is measured with a phoropter, the instrument used when the doctor asks, "Which one is better, one or two?" Doctors also use a wavefront aberrometer to see how the astigmatism affects the quality of your vision.

Are there other ways to correct astigmatism?

While most people who have astigmatism can have LASIK, some people have too much astigmatism for the laser to correct. However, sometimes, people can have an additional procedure called astigmatic keratectomy (AK) to correct any remaining astigmatism. Astigmatic keratectomy uses a procedure made popular in the 1980's called RK, or radial keratectomy. In an AK procedure, a skilled refractive surgeon makes small incisions in certain key places in the cornea to make the cornea more spherical. This is sometimes combined with another incisional procedure called a LRI, or limbal relaxing incision. A LRI is made at the opposite edges of the cornea which causes a slight flattening in that direction.

A thorough evaluation of your vision will be required to determine if you are a candidate for LASIK. The type and severity of your astigmatism will help your ophthalmologist decide if LASIK eye surgery will be beneficial to you. Some people with astigmatism should not have LASIK, as some qualities and characteristics of their eyes prevent them from having a successful outcome.

Source:

Azar, Dimitri T. and Douglas D. Koch. "LASIK: Fundamentals, Surgical Techniques, and Complications." Marcel Dekker, Inc. Copyright 2003.

Continue Reading