LASIK for Astigmatism

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What is LASIK?

LASIK is an FDA-approved laser eye surgery that corrects vision problems (refractive errors). It stands for laser-assisted in situ keratomileusis. LASIK surgery is beneficial for most people who wear glasses or contact lenses. Many people who undergo the surgery no longer need corrective eyewear.

LASIK can correct:

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Presbyopia (age-related vision changes)
  • Astigmatism (misshapen cornea)

During the procedure, your eye surgeon creates a thin, hinged flap incision into the cornea. A laser then removes inner layers of the cornea in order to give it a better shape. 

diagram showing six steps of lasik eye surgery

Compared to other corneal surgeries, this laser eye surgery offers quicker and more pleasant recovery experiences.

What is Astigmatism? 

Astigmatism is a type of refractive error. It means the curvature of your eye’s cornea or lens is irregular. The curvature is sometimes comparable to the shape of a football or egg. This eye condition can affect how light passes through the cornea and lens and refracts (bends) onto the retina. A refractive error of this kind can make viewing objects challenging. 

diagram showing eye with normal vision vs astigmatism

Symptoms of astigmatism include:

  • Blurred vision (distance or near vision)
  • Fluctuating vision
  • Eyestrain
  • Dry eyes
  • Squinting
  • Headaches
  • Poor night vision (glare or starburst patterns around lights)
  • Sensitivity to light

Many people have astigmatism along with another refractive error. This could be myopia or hyperopia (nearsightedness or farsightedness).

Can I get LASIK Surgery if I have Astigmatism?

Yes, LASIK can fix astigmatism. Laser eye surgery can correct up to approximately 6.00 D of astigmatism. If you also have myopia or hyperopia, LASIK may not be able to provide this much correction for astigmatism. A LASIK specialist can provide medical advice as to whether you're a good candidate for laser eye procedures.

The LASIK procedure is a simple process. The steps include:

  1. A topical (eye drop) anesthetic is squeezed into the eye before surgery 
  2. Using a femtosecond laser to create a small flap in the cornea’s epithelium (the outer protective barrier on the eye)
  3. A LASIK surgeon then separates the tissue and folds back the thin flap to one side
  4. Laser energy is then applied for a few seconds to a minute to reshape the corneal tissue underneath the flap
  5. Once completed, the surgeon places the flap back into its original spot for natural healing

The reshaping of your cornea corrects your refractive error and allows your eye to bend light correctly. This should improve your visual acuity, eliminating or greatly reducing your blurry vision.

Benefits of LASIK For Astigmatism Correction

LASIK surgery has many advantages for those with astigmatism, including:

  • Speed and safety. This surgical procedure is performed on an outpatient basis. In some cases, the surgery may take approximately 20 minutes. Regardless of the time, the laser is safe, having an automatic shut-down function in case of any sudden eye movements. 
  • Earlier results. Clear vision does not take long to arrive after LASIK eye surgery. Individuals undergoing the procedure may notice a positive difference within a few hours after surgery. 
  • Better vision for more extended periods. A surgery like this can result in improved vision for long, if not permanent, periods. This means that individuals may not need to continue wearing glasses or contacts to enjoy regular activities.  

How Successful is LASIK for Astigmatism?

LASIK has very high success rates for correcting astigmatism. According to the American Refractive Surgical Council:

"The latest research reports 99 percent of patients achieve better than 20/40 vision and more than 90 percent achieve 20/20 or better. In addition, LASIK has an unprecedented 96 percent patient satisfaction rate – the highest of any elective procedure"

American Refractive Surgical Council

Cost of LASIK Surgery For Astigmatism

Laser vision correction procedures may vary in price according to different factors. 

In general, the average cost of LASIK in the United States is around $2,500 per eye. LASIK may be more expensive for patients with astigmatism, but it depends on the eye surgeon's rates.

This price may include the initial consultation as well as follow-up care. However, as each eye care clinic is different, it is important to speak with the ophthalmologist about an itemized quote. 

Additional factors that may influence costs for this type of refractive surgery include:

  • Types of astigmatism. The severity of astigmatism may influence the length and costs of the procedure. In more extreme cases, LASIK may not even be a suitable option. 
  • Insurance plans. Many insurance companies consider LASIK as elective surgery. This means your vision benefits may not cover the costs of the surgical procedure. 
  • Advanced LASIK technology. The latest LASIK procedures can now include wavefront and/or topographical analysis of the eyes for more precision. This aspect, while positive, can push up the final costs. 

Does Insurance Cover LASIK For Astigmatism?

Unfortunately, most health plans consider laser surgery an elective treatment. Elective procedures are usually not covered by traditional insurance plans. However, some vision insurance companies are starting to offer discounts on LASIK.

Some vision insurance policies that offer discounts include:

  • Vision Service Plan (VSP)
  • EyeMed
  • Davis Vision
  • MESVision
  • Spectera

If you get one of these plans, you'll probably have to use an in-network eye doctor for your LASIK treatment. They usually have contracts with specific LASIK clinics. This is helpful because the surgeons in these networks have been vetted and approved by the insurance company to provide comprehensive LASIK treatment to correct astigmatism.

Is LASIK Right for Me?

LASIK surgery is a viable option for most patients with astigmatism. However, there are certain conditions that may disqualify you for LASIK. Speak with your ophthalmologist to find out if you're an ideal candidate for LASIK.

An Ideal Candidate for LASIK:

  • Is at least 18 years old
  • Has good overall health
  • Has good eye health
  • Not pregnant or nursing
  • Not planning on becoming pregnant for at least six months after surgery

You Should NOT Get LASIK If:

  • You have a thin cornea (keratoconus deteriorates your cornea). If you even have a family history of keratoconus, you may not be an ideal candidate for laser eye surgery
  • Your glasses or contact lens prescription has changed in the last year (refractive instability)
  • You have glaucoma, cataracts, or certain other eye conditions
  • You have keratitis, uveitis, herpes, or other eye infections
  • You have an autoimmune disease that could interfere with healing
  • You have large pupils (this can cause glare, halos, double vision, and starbursts after surgery)
  • You have chronic dry eyes
  • You are an athlete in a contact sport where blows to the face or eyes are common
  • You are on certain medications such as corticosteroids and certain acne medications

Alternative Treatment Options For Astigmatism

If an individual decides not to undergo LASIK surgery, there are other options available. 

Before determining treatment and/or corrective lenses, an eye doctor will perform an eye exam to understand the cornea’s shape.  

In many cases, individuals can address mild to moderate astigmatism problems with eyeglasses or contact lenses. One example is a type of soft lenses called toric contact lenses. However, it may be more suitable for individuals who have severe astigmatism to wear rigid contacts or glasses.

Another treatment option is photorefractive keratectomy (PRK). This surgical procedure is similar to LASIK. However, the surgeon does not leave the cornea’s outer protective layer as a flap. Instead, the layer is removed, and the tissue grows back naturally to fit the reshaped cornea. 

A primary reason why individuals may be a good candidate for PRK than LASIK is corneal thickness. If the cornea is too thin, there is not enough tissue for surgeons to create a flap in the superficial layer of the cornea. This step is essential in LASIK surgery. 

However, individuals who consider undergoing PRK should know that recovery time is different from that of LASIK. With PRK, recovery periods are often much longer. 

In any case, it is always best to stop by an ophthalmology clinic and speak with an eye health professional about any invasive or non-invasive treatment options. 

Resources
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Boyd, Kierstan. “What Is Astigmatism?” American Academy of Ophthalmology, 7 Sept. 2018, www.aao.org/eye-health/diseases/what-is-astigmatism.

“Evaluating A LASIK Bargain: 4 Facts You Need To Know.” American Refractive Surgery Council, 30 Apr. 2020, www.americanrefractivesurgerycouncil.org/evaluating-lasik-price-bargain/.

Joy, Kevin. “Pros and Cons of LASIK: Are the Risks Worth the Cost?” Health & Wellness Topics, Health Tips & Disease Prevention, 13 Dec. 2017, www.healthblog.uofmhealth.org/eye-health/pros-and-cons-of-lasik-are-risks-worth-cost

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