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Can Astigmatism Be Corrected After Cataract Surgery?

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An ophthalmologist is pointing his finger at an eye model while explaining how cataract surgery is being done and how to correct astigmatism.

If you need to have cataracts removed, can refractive errors be corrected at the same time? While you may not link the two conditions together, cataracts and astigmatism can be addressed in the same procedure.

When cataracts start limiting your ability to drive, read, shop, climb stairs, or maintain your independence, our optometrists may recommend intervention.

Cataract surgery is a safe procedure and, when combined with astigmatism correction, can help give you crisp, clear vision without relying on strong prescription lenses. 

What Is Astigmatism?

Astigmatism is a common condition where the surface of the eye or lens is irregular in shape or cylindrical. The misshapen cornea or lens inhibits light from focusing on the retina, causing blurred vision at all distances.

Mild astigmatism of less than 1.00 diopter is normal, and you may not need corrective lenses to fix it yet. Moderate astigmatism of 1.00 to 2.00 diopter requires prescription glasses or contacts to see clearly. With severe astigmatism of 2.00 to 3.00 diopter, the symptoms can affect daily functioning and cause headaches.

Glasses and contact lenses can correct astigmatism, and the higher your astigmatism, the worse your vision will be without corrective lenses. It will never go away on its own, but if you’re removing cataracts, you can also correct astigmatism during the surgery.

What Is a Cataract?

A cataract is a clouding of the lens of the eye. Those with cataracts have trouble seeing as the clouding causes blurry spots in their vision. Signs and symptoms of cataracts include:

  • Blurred vision
  • Double vision
  • Sensitivity to light and glare
  • Rapidly changing eyeglass prescription
  • Difficulty with vision at night

Cataracts develop slowly, and while bright light and glasses can help at first, vision can deteriorate to the point where you need surgery.

Can You Correct Astigmatism During Cataract Surgery?

Cataract surgery involves the removal of the lens in your eye and replacing it, commonly with an artificial lens. As cataracts worsen your vision by blurring your sight and causing glare from lights, our optometrists may recommend cataract surgery to improve your quality of life.

Almost every patient who has cataract surgery will get an artificial intraocular lens (IOL) to correct vision. Various types of lenses are available for implantation, including:

  • Multifocal lenses similar to bifocal or progressive lenses in glasses
  • Fixed-focus monofocal lenses with a single focus strength for distance vision
  • Accommodating-focus monofocal lenses with a single focus that can respond to eye movements and shift focus at different distances
  • Toric lenses for astigmatism

Toric Lenses

Toric IOLs can help you recapture clear, sharp vision and improve distance vision. With astigmatism, different parts of your eye need different prescriptions to focus light. Unlike spherical IOLs, which are consistent across the lens, toric lenses have separate prescriptions for every area of the lens.

The use of toric IOLs in cataract surgery is one of the most well-studied ways to correct astigmatism during cataract surgery and poses no extra risk to the procedure. Toric lenses can correct powerful astigmatism up to 6.00 diopter, making them the best option for high astigmatism.

Astigmatism Correction

A small incision in the cornea to access the natural lens where the cataract is. The surgeon will break up the lens with an ultrasound probe in a process called phacoemulsification before removing the remaining fragments. The lens capsule will be left intact to place the artificial toric IOL.

The toric IOL won’t completely correct your astigmatism, so you’ll need an eye exam after surgery to find your new glasses or contact lens prescription.

Other Surgical Methods to Correct Astigmatism

Less common methods to correct astigmatism at the time of cataract surgery include:

  • Limbal relaxing incisions (LRIs) can correct astigmatism by flattening the curve of the cornea and letting the eye heal into a spherical shape. LRIs can be customized to the shape and size of the cornea
  • Clear Corneal Incision (CCI) aligns the main surgical incision with the steep axis of the cornea to decrease the astigmatism

Laser Eye Surgery Consultation with Aurora Eye Care

If you’re struggling with cataracts, or refractive errors like astigmatism, nearsightedness, and farsightedness, Aurora Eye Care offers laser eye surgery consultations to examine your eyes to determine if surgery is right for you.While we don’t perform eye surgeries, our team is here to support you in pre- and post-operative care and work with surgeons to give you the best vision possible. Book a consultation to learn more about which laser eye surgery suits your vision needs best.

Written by Dr. Kyla Hunter

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