How good is LASIK at fixing an astigmatism?

by Lance Kugler, MD

This question was recently posted on Quora (

Here is my answer: Astigmatism is a complicated topic. Astigmatism means that the eye is not perfectly round, like a basketball, but more like a football. An eye that is shaped this way focuses the light in two different planes thus there is natural blur at all distances.

It used to be that astigmatism could not be corrected by LASIK or other laser eye surgery, but with modern techniques that is no longer true. Even older less-sophisticated laser systems can correct astigmatism reasonably well. However when it comes to astigmatism simply correcting the measured astigmatism in the patient’s glasses prescription is not always adequate. That is because there may be astigmatism inside the eye arising from the lens or other structures.

This is called Ocular Residual Astigmatism (ORA). In order to appropriately treat eyes with high ORA, one must use vector analysis to determine the appropriate treatment magnitude. Doing so ensures the astigmatism is corrected appropriately for the patient’s lifetime! Here are some references that explain this concept in more detail: Kugler L, Cohen I, Haddad W, Wang MX. Efficacy of laser in situ keratomileusis in correcting anterior and non-anterior corneal astigmatism: comparative study. J Cataract Refract Surg. 2010 Oct;36(10):1745-52.   To learn more about Astigmatism, click here!   –Lance Kugler, MD

kugler vision doctor lance kugler

Lance Kugler, MD, is a specialist in LASIK and vision correction surgery and CEO of Kugler Vision. A proud Omaha native, he is passionate about improving lives through clear vision. Dr. Kugler serves on several national boards, and his practice is recognized internationally as a center of excellence. Dr. Kugler is one of the original founders of the Refractive Surgery Alliance, an international organization comprised of over 350 of the world’s leading vision correction surgeons; he also served as its first president. In 2019, Dr. Kugler was selected as a TEDx speaker, and delivered a talk in Omaha about the worldwide epidemic of nearsightedness and refractive solutions. Dr. Kugler is an Associate Professor of Refractive Surgery at the University of Nebraska Medical Center’s Truhlsen Eye Institute, has been published in many medical journals, and participates in numerous clinical studies to advance the field of vision correction surgery. Dr. Kugler and his wife are proud parents to five active kids. When he has a spare moment, he enjoys skiing, tennis, travel, and fine coffee.

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