Cataract Surgery & Astigmatism

Reviewed by:

Jason Jacobs, MD

It is important to know a little about astigmatism and Cataract Surgery because this refractive condition can affect your ultimate vision correction after your Cataracts are removed, and thus your overall satisfaction with your surgery.

Astigmatism is a common refractive eye condition that, depending on its type and severity, may cause blurred vision. Generally astigmatism is caused by the Cornea having an irregular shape. The Cornea of a perfectly shaped eye has a smooth spherical surface, like a basketball. In eyes that have astigmatism, the Cornea will have more of an oblong, football-like shape, kind of like the shape of the back of a teaspoon.

Astigmatism does not always require correction in order to achieve good vision. Many people have some astigmatism. But, if only a small degree of astigmatism is present you may not even notice it, as it will not disturb your vision. Greater degrees of astigmatism do cause a blurring and sometimes a shadowing of vision and thus require correction in order to help you see your best.

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Astigmatism can be pre-existing, meaning that it is present as part of your refractive error before your cataract surgery, or it can be post-surgical meaning that it occurred as part of your eye’s healing response you’re your Cataract Surgery.

Pre-existing astigmatism can be corrected as part of your Cataract Surgery to improve your vision and help you be less dependent on glasses or perhaps not even have to wear eyeglasses at all to see clearly at distance after your Cataract Surgery. Pre-existing Corneal astigmatism can be corrected during your cataract Surgery by two methods:

  • A procedure called LRI or Limbal Relaxing Incisions allows your surgeon to place small peripheral incisions in the Cornea to “relax” the astigmatism, or

limbal relaxing incision, LRI

  • Implantation of astigmatism correcting “toric” lens implants or IOLs. Which procedure is right for you depends on the degree of astigmatism to be corrected. In some instances it may be necessary to have both a toric lens implant and an LRI to achieve your goal of not needing glasses to see clearly at distance after your Cataract Surgery. In a small number of cases it might even be necessary to have a Laser Eye Surgery procedure such as LASIK or PRK if you have a very large amount of astigmatism. Your Cataract Surgeon will fully discuss these options with you if you have pre-existing and may require both types of procedures or even LASIK/PRK if there are large amounts of astigmatism.

Post-surgical astigmatism can be corrected after your Cataract Surgery to improve your vision and help you be less dependent on glasses or perhaps not even have to wear eyeglasses at all to see clearly at distance after your Cataract Surgery. Post-surgical astigmatism can be corrected by two methods:

  1. The LRI procedure as discussed previously, or
  2. A Laser Eye Surgery procedure such as LASIK or PRK.

Again, should you have post-surgical astigmatism that requires correction, and if you do not wish to wear eyeglasses or contact lenses to correct the post-surgical astigmatism, your Cataract Surgeon will make specific recommendations on what options will help you achieve your vision correction goals.

The information that has been provided here is intended to give patients an overview of Cataract Surgery and astigmatism. It is possible that your individual experience might be different. None of the information provided here is meant to be a substitute or replace your physician’s consultation nor does it replace the need for you to consult with your surgeon about specific details of Cataract Surgery, astigmatism, LRI Limbal Relaxing Incisions or Toric Lens Implants.

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