Laser Eye Surgery with Astigmatism: What You Need to KnowAre you fed up with blurry vision and always adjusting your glasses? If you have astigmatism, you might’ve wondered if laser eye surgery could fix your problem. This article will provide information to help you understand if laser eye surgery might be right for you.Astigmatism can make everyday tasks like reading or driving difficult. But here’s some good news: current laser eye surgery methods have improved significantly in treating this common vision issue.This article explores key aspects of laser eye surgery for astigmatism, whether you’re thinking about getting it done or just curious about your options. We’ll cover everything from understanding how the procedure works to learning about recovery and results.And if you’re in South Australia and considering laser eye surgery Adelaide (LASIK), you can use our free online suitability test to help you gather information about the procedure, but a comprehensive assessment by an eye specialist is essential for determining your individual suitability. Alternatively, if you can always call us on 08 7082 2066 at or book an appointment here.But first, let’s look at laser eye surgery and astigmatism.Laser Eye Surgery with AstigmatismLaser eye surgery for astigmatism has changed how we correct vision problems. It’s a procedure that uses advanced laser technology to reshape the cornea, the clear front part of your eye. By doing this, it can fix the irregular curvature that causes astigmatism, potentially freeing you from needing glasses or contact lenses.The surgery usually takes only about 15 to 30 minutes for both eyes. 1Saragoussi JJ, Djadi-Prat J, Lebuisson DA, et al. Quality of life after LASIK: part II. Quality of life and satisfaction of a population of patients treated with LASIK It’s done with local anaesthesia, so you’re awake but comfortable throughout. Most people notice better vision within a day or two, with full results typically settling in over a few weeks to months.Is Laser Eye Surgery Safe for Treating Astigmatism?Safety is naturally a top concern when it comes to your eyes. The good news is that laser eye surgery for astigmatism is generally considered very safe when done by a skilled and experienced surgeon.Technological advancements have contributed to improved precision and safety in laser eye surgery for astigmatism, thanks to advances in technology and surgical methods. Today’s lasers are incredibly precise, and the procedure is customised to each patient’s unique eye shape and vision needs.Before surgery, you’ll have a thorough eye exam to make sure you’re a good candidate. This helps to further reduce risks by identifying any potential issues beforehand.Many patients report positive experiences with laser eye surgery for astigmatism, achieving improved vision and independence from glasses or contacts. Many report improved quality of life and freedom from the hassles of glasses or contacts. 2Saragoussi JJ, Djadi-Prat J, Lebuisson DA, et al. Quality of life after LASIK: part II. Quality of life and satisfaction of a population of patients treated with LASIKDifferent Types of Laser Eye Surgery for AstigmatismThere’s no single approach that works for everyone when it comes to treating astigmatism with laser eye surgery. Different techniques can be used, each with its own benefits and considerations. Let’s look at the main types of laser eye surgery available for astigmatism correction.In case you want to better understand how laser eye surgery works, read this article: Laser Eye Surgery: How Does It Work?LASIK (Laser-Assisted In Situ Keratomileusis)LASIK is probably the most well-known type of laser eye surgery. It’s a popular choice for treating astigmatism because recovery is quick and there’s minimal discomfort.3Durrie, D.S. (2012) Evaluating the speed of visual recovery following thin-flap LASIKDuring LASIK, the surgeon creates a thin flap in the cornea using either a laser or a special blade. This flap is then lifted, and an excimer laser reshapes the underlying corneal tissue to correct the astigmatism. The flap is then put back, acting as a natural bandage.One of the big advantages of LASIK is that most people have better vision within 24 hours.4Durrie, D.S. (2012) Evaluating the speed of visual recovery following thin-flap LASIK It’s also known for causing less discomfort compared to other types of laser eye surgery.PRK (Photorefractive Keratectomy)PRK is another effective option for treating astigmatism. It was actually the first type of laser eye surgery developed. In PRK, instead of creating a flap, the surgeon removes the outer layer of the cornea (epithelium) completely. Then, similar to LASIK, an excimer laser reshapes the cornea to correct the astigmatism. The epithelium then grows back naturally over the following days. 5Probst, The Optimization of LASIK, International Ophthalmology Clinics 48(1):p 9-16, Winter 2008. https://journals.lww.com/internat-ophthalmology/citation/2008/04810/the_optimization_of_lasik.5.aspxPRK can be a good choice for people with thinner corneas who might not be suitable for LASIK. However, the recovery time is typically longer than with LASIK, and there may be more discomfort in the first few days after surgery.SMILE® Pro (Small Incision Lenticule Extraction Pro)SMILE® Pro is a newer technique that may offer specific advantages for certain patients with astigmatism. Your eye surgeon can advise you on its suitability for your individual case.During SMILE® Pro, the surgeon uses a sophisticated femtosecond laser to create a small, lens-shaped bit of tissue (lenticule) within the cornea.6Ekktet Chansue et al, Efficacy, predictability and safety of small incision lenticule extraction (SMILE),2, Article number 14, Published: 31 August 2015 https://link.springer.com/article/10.1186/s40662-015-0024-4 This lenticule is then removed through a tiny incision. By removing this tissue, the shape of the cornea is changed, correcting the astigmatism.SMILE® Pro is less invasive than LASIK, as it doesn’t require creating a flap. This can mean a quicker recovery time and less risk of dry eye symptoms. It also offers enhanced precision and potentially better visual outcomes compared to standard SMILE. 7Probst, The Optimization of LASIK, International Ophthalmology Clinics 48(1):p 9-16, Winter 2008. https://journals.lww.com/internat-ophthalmology/citation/2008/04810/the_optimization_of_lasik.5.aspxSMILE® Pro is suitable for a wider range of prescriptions, but your eye surgeon will advise if it’s the best option for you.Eligibility Criteria For Laser Eye Surgery With AstigmatismBefore you get too excited about the idea of getting rid of your glasses, it’s important to know that not everyone with astigmatism can have laser eye surgery. There are several factors that eye surgeons consider when determining if you’re eligible. Let’s break these down.Age and Eye StabilityOne of the first things your eye doctor will look at is your age and the stability of your vision. Typically, you need to be at least 18 years old to have laser eye surgery. This is because your eyes can continue changing into your late teens or early twenties.Even if you’re over 18, your vision needs to be stable. This means your prescription shouldn’t have changed significantly in the past year or two. If your astigmatism is still getting worse, it’s usually best to wait until it stabilises before considering surgery.Degree of AstigmatismHow severe your astigmatism is also plays a role in determining your eligibility. Most modern laser systems can treat a wide range of astigmatism, but there are limits. Very high degrees of astigmatism might be better treated with other methods, like implantable contact lenses.Your eye doctor will measure your astigmatism precisely to determine if it falls within the treatable range for laser surgery.Corneal Thickness and ShapeThe thickness and shape of your cornea are very important in determining your eligibility for laser eye surgery. The procedure involves removing small amounts of corneal tissue, so you need to have enough corneal thickness to allow for this safely.If your corneas are too thin, or if you have certain corneal conditions like keratoconus, you might not be a good candidate for laser surgery. In these cases, your eye doctor might recommend other treatments.Overall Eye HealthYour eyes need to be healthy overall for laser eye surgery to be safe and effective. Conditions like cataracts, glaucoma, or certain retinal problems might mean you can’t have the procedure.Your eye doctor will do a comprehensive eye exam to check for any issues that could complicate surgery or affect your results.General Health and MedicationsYour general health can also affect your eligibility for laser eye surgery. Certain autoimmune diseases or conditions that affect wound healing might make the surgery riskier.Some medications can also interfere with the surgery or healing process. For example, some acne medications can affect corneal healing. Be sure to tell your eye doctor about all medications you’re taking, including over-the-counter drugs and supplements.Pregnancy and BreastfeedingIf you’re pregnant or breastfeeding, you’ll need to wait before having laser eye surgery. Hormonal changes during these times can temporarily affect your vision and could impact the accuracy of the surgical correction.Realistic ExpectationsHaving realistic expectations is an important part of the decision-making process for laser eye surgery. Your eye surgeon will discuss potential outcomes and any limitations based on your individual circumstances. The procedure can significantly reduce your need for glasses or contacts, but it may not completely eliminate the need for them in all situations.Your eye doctor will discuss what you can realistically expect from the surgery based on your specific case of astigmatism.Pre-Operative Assessments And Measurements For Astigmatic CorrectionBefore you have laser eye surgery for astigmatism, you’ll go through a series of detailed assessments and measurements. These are essential for planning your treatment and ensuring the best possible outcome. Let’s look at what you can expect during this pre-operative phase.Comprehensive Eye ExamThe first step is usually a thorough eye examination. This goes beyond just checking your vision — your doctor will look at every aspect of your eye health.They’ll dilate your pupils to examine the back of your eye, check for any signs of eye disease, and assess how well your eyes work together. This exam helps ensure your eyes are healthy enough for surgery and that there are no underlying issues that could affect your results.Corneal TopographyCorneal topography is a key measurement for planning astigmatism correction. It’s like creating a map of your eye’s surface. Using a specialised instrument, your eye doctor will capture detailed images of your cornea. These images show the exact shape and curvature of your cornea, including the irregular shape that causes your astigmatism.This information is essential for planning precisely where and how much tissue needs to be removed during the laser procedure.Wavefront AnalysisMany eye surgeons now use wavefront analysis as part of their pre-operative assessment. This technology measures how light travels through your eye, creating a highly detailed map of your vision.Wavefront analysis can detect even tiny imperfections in your vision that go beyond standard measures of astigmatism. This information can be used to create a customised treatment plan that addresses not just your astigmatism, but other subtle vision irregularities as well.Pupil Size MeasurementYour surgeon will measure your pupil size in different lighting conditions. This is important because pupil size can affect your vision after surgery, especially in low light.If you have large pupils, you might be more prone to nighttime visual disturbances after surgery. Knowing your pupil size helps your surgeon plan the treatment zone to minimise these potential effects.Corneal Thickness MeasurementWe mentioned corneal thickness as an eligibility criterion earlier. This is where it gets measured precisely. Using a technique called pachymetry, your eye doctor will measure the thickness of your cornea at various points. This helps determine if you have enough corneal tissue to allow for safe reshaping during the surgery.Tear Film EvaluationThe quality and quantity of your tears play a role in the health of your eye surface and can affect healing after surgery. Your eye doctor will evaluate your tear film to check for any issues like dry eye syndrome.If you do have dry eyes, it doesn’t necessarily rule out surgery, but it might mean you need treatment to improve your tear film before having laser eye surgery.Refraction TestsOf course, your eye doctor will also perform detailed refraction tests to precisely measure your astigmatism and any other vision problems you might have.These tests often include both automated measurements and manual “fine-tuning” by your eye doctor. The goal is to get the most accurate measure of your vision correction needs.The Laser Eye Surgery Procedure: What To Expect During TreatmentNow that we’ve covered the pre-operative assessments, let’s walk through what actually happens during the laser eye surgery procedure for astigmatism. While the exact steps can vary depending on the specific technique being used (like LASIK or PRK), here’s a general overview of what you can expect:Preparation: Your eye will be cleaned and numbed with anaesthetic drops. You’ll feel the drops, but they don’t hurt.Positioning: You’ll lie back in a reclining chair. The surgeon will position your head and may use a gentle device to keep your eyelids open.Corneal Flap Creation (for LASIK): If you’re having LASIK, the surgeon creates a thin flap in your cornea. You might feel some pressure, but it’s not painful.Laser Reshaping: The laser part of the procedure begins. You’ll be asked to look at a target light while the laser reshapes your cornea. You’ll hear a clicking sound but won’t feel anything.Flap Replacement (for LASIK): If a flap was created, it’s carefully repositioned. It adheres naturally and begins healing immediately.Protective Shield Placement: A clear protective shield is placed over your eye to prevent you from rubbing it or putting pressure on it while it heals.Repeat for Other Eye: If you’re having both eyes treated, the process is repeated for the second eye. The entire procedure usually takes about 30 minutes for both eyes.Brief Rest: You’ll rest for a short while after the procedure. Your vision will be blurry at first, but you should notice improvement within a few hours.Post-Op Instructions: Before you leave, you’ll receive detailed instructions for your recovery, including how to use your eye drops and when to return for follow-up appointments.Arranging Transport Home: You won’t be able to drive immediately after the procedure, so make sure you’ve arranged for someone to take you home.Recovery Timeline and Post-operative Care for Astigmatism PatientsThe recovery process after laser eye surgery for astigmatism is generally smooth, but it varies slightly depending on the procedure.For LASIK, most people can resume normal activities within a day or two, although it’s important to avoid strenuous activities for at least a week. PRK patients may experience a longer recovery time, with vision stabilising after about a week.Post-operative care is essential for a successful outcome. You’ll be prescribed eye drops to prevent infection and keep your eyes moist. It’s important to use them as directed. Additionally, you should avoid rubbing your eyes for several weeks after surgery, as this can interfere with the healing process.It’s common to experience dry eyes, glare, or sensitivity to light in the days following surgery. These symptoms usually subside within a few weeks. Regular follow-up appointments with your eye doctor will ensure everything is healing properly and that your vision is improving as expected.Common Myths About Laser Eye Surgery and Astigmatism DebunkedThere are many myths surrounding laser eye surgery, and it’s important to separate fact from fiction. Let’s address some of the most common misconceptions.Myth 1: Laser Eye Surgery Is PainfulThis is one of the most common myths, but the reality is that the procedure is virtually painless. Numbing eye drops are used to ensure you won’t feel anything during the surgery. You might experience slight discomfort or pressure, but nothing severe.Myth 2: Astigmatism Can’t Be Corrected with Laser SurgeryMany people believe that laser eye surgery only works for nearsightedness or farsightedness. However, modern laser techniques are highly effective at treating astigmatism as well.Myth 3: The Results Aren’t PermanentWhile it’s true that some people may need a touch-up surgery years down the line, most patients enjoy permanent results. The key is having stable vision before the procedure.Success Rates and Outcomes of Laser Eye Surgery for AstigmatismThe success rate of laser eye surgery for astigmatism is very high, with most patients achieving 20/20 vision or better after the procedure.In fact, studies show that more than 90% of patients are satisfied with their results. The outcome largely depends on the severity of the astigmatism and the patient’s overall eye health.Patients who undergo LASIK or PRK for astigmatism usually notice an immediate improvement in their vision, and this continues to improve over the following weeks as the eyes heal. 8Saragoussi JJ, Djadi-Prat J, Lebuisson DA, et al. Quality of life after LASIK: part II. Quality of life and satisfaction of a population of patients treated with LASIK [in French]. J Fr Ophtalmol. 2011;34:294–302While laser eye surgery can’t guarantee perfect vision for every patient, it offers a significant improvement in most cases, allowing patients to reduce or eliminate their need for glasses or contacts.Closing thoughtsLaser eye surgery has greatly improved the treatment of astigmatism, offering a safe and effective way to correct this common vision problem. From LASIK to PRK and newer techniques like SMILE® Pro, there are now several options available to suit different eyes and different needs.While the idea of eye surgery might seem scary at first, the high success rates and low risk of complications make it an attractive option for many people tired of relying on glasses or contacts. Of course, it’s not the right choice for everyone, which is why thorough pre-operative assessments and honest discussions with your eye care professional are so important.If you’re considering laser eye surgery for astigmatism, we encourage you to schedule a consultation with our team at IVISION LASER to learn more about your options. The team at IVISION LASER has experience in laser eye surgery and can offer personalised advice based on your specific needs.FAQsHow long does laser eye surgery for astigmatism take?The procedure itself usually takes about 15-30 minutes for both eyes. However, you should plan to be at the clinic for a few hours on the day of surgery.Will I be awake during the surgery?Yes, you’ll be awake during the procedure. However, you’ll be given numbing eye drops so you won’t feel any pain.Can astigmatism come back after laser eye surgery?While the correction made during surgery is permanent, your eyes can still change over time. Some people might develop new astigmatism years after surgery, but this isn’t the original astigmatism “coming back.”How soon after surgery can I drive?Most people can drive within a day or two after LASIK, or about a week after PRK. However, wait until your doctor gives you the okay.Will laser eye surgery eliminate my need for glasses?While many people find they no longer need glasses for most activities after surgery, some might still need them for certain tasks, especially as they age. The goal is to reduce your dependence on glasses, not necessarily eliminate them entirely.Are you considering laser eye surgery in Adelaide? Then check out our free online suitability test. You can also call us on 08 7082 2066 or book an appointment here. Take the first step towards clearer vision and a life free from the limitations of glasses or contact lenses.