How good is LASIK at fixing an astigmatism?

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 the Founder and Physician CEO of Kugler Vision in Omaha, Nebraska. Following a year of specialty training, during which he performed over 1300 refractive surgical procedures, Dr. Kugler returned to Omaha to bring the latest state-of-the-art LASIK and cataract surgery technology to Nebraska. Dr. Kugler serves as Director of Refractive Surgery for the University of Nebraska Medical Center, where he is in charge of resident education and research programs to advance the field of refractive surgery.

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