Can You Correct Astigmatism With Cataract Surgery?

Reviewed by: Jason Jacobs, M.D. and Leslie Doctor, M.D.

Question: For as long as I can remember my eyeglasses have had a prescription to correct for astigmatism. Now I have a Cataract and my eye surgeon says I should I have a lens implant that corrects the astigmatism instead of having to wear the eyeglasses to see distance after my Cataract operation. The thing is, they want to charge me more and I will have to pay it out of pocket for the astigmatism lens implant. Is this correct?

Answer: If you have had astigmatism correction in your eyeglasses for many years, you have what is called “pre-existing astigmatism”. That is, that it was there before your Cataract even formed and before your Cataract Surgery. Since you have always had corrected in the past, you will need to have it corrected as part of your Cataract Surgery or else will have to wear eyeglasses that correct the astigmatism after your Cataract surgery. One way or another, the astigmatism has to be corrected for you to have the best possible vision after Cataract Surgery. One way to correct astigmatism as part of a cataract operation is to perform a secondary procedure called Limbal Relaxing Incisions (LRI). For some patients with certain types and degree of astigmatism this may be an option. Keep in mind that it is a secondary surgical procedure and thus has incremental cost associated with it that your insurance and Medicare does not cover. You are actually very fortunate. Today, your Cataract can be removed and the crystalline lens replaced with an intraocular lens implant (IOL) that corrects your entire prescription-including the astigmatism. The type of intraocular lens implant (IOL) that corrects astigmatism is called a “toric lens implant”. Many insurance plans, as well as Medicare, only pay for the insertion of “basic” monofocal lens implants that do not correct astigmatism. They ask the Cataract surgeon or Cataract surgery center to bill the patient separately for the toric lens implant. The typical cost of the toric lens implant can range from $1,000 to $2,000 per eye depending on the type of lens and geographic location.

So, the simple answer to the question “Can I have a lens implant to correct astigmatism with Cataract surgery and does it cost more? is yes. As always, choose a reputable Cataract Surgeon with experience in performing Cataract Surgery with toric lens implants for astigmatism correction who takes the time necessary to evaluate you properly and guide you through the right decisions.

The information that has been provided here is intended to give patients a basic understanding of Cataracts and correction of astigmatism after Cataract Surgery. It is possible that your individual experience might be different. None of the information provided here is meant to be a substitute for or replace your eye doctor's consultationnor does it replace the need for you to consult with your Cataract Surgeon about specific details of Cataract Surgery and Intraocular Lens (IOL) Implantation.

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