Medically reviewed by Krishna Surapaneni, MD, board-certified ophthalmologist and cataract, cornea, and refractive surgeon at SuraVision in Houston.
If you have astigmatism and you are heading toward cataract surgery, you may be wondering whether one operation can take care of both. The short answer is yes, in most cases cataract surgery can be planned to reduce astigmatism at the same time it removes your cataract. It takes some measuring and a clear plan, and this page walks through how it works, what it costs, and what to expect.
First, what astigmatism actually is
Astigmatism is simply a matter of shape. A cornea without astigmatism is curved evenly, more like a basketball. A cornea with astigmatism is curved more like a football, steeper in one direction than the other. That uneven shape bends light unevenly, which can leave vision a little blurry or stretched at both near and far distances. It is very common, and by itself it is nothing to worry about. You can read more from the American Academy of Ophthalmology.
Yes, cataract surgery is a chance to correct it
Here is why cataract surgery and astigmatism go together so well. During cataract surgery, your cloudy natural lens is removed and a clear artificial lens is put in its place. Because your surgeon is already choosing and placing a new lens, that same visit is a natural opportunity to address astigmatism.
One thing to know: a standard cataract operation with a basic lens does not automatically erase astigmatism. Correcting it takes a specific choice, made ahead of time based on careful measurements of your eye. When that planning is done, many patients end up depending on glasses far less than they did before.
The two main ways astigmatism gets corrected
There are two proven approaches, and sometimes they are used together.
A toric lens implant
A toric lens is an artificial lens with astigmatism correction built right into it. It does the job of a normal cataract lens and corrects astigmatism at the same time. Many premium lenses, including extended depth of focus lenses such as PureSee and full-range lenses, come in a toric version. If you want to see how those lens choices compare, our guide to comparing premium cataract lenses goes through them in plain English.
Laser astigmatism correction
Astigmatism can also be treated on the cornea itself. A femtosecond laser can make precise, gentle corneal treatments that reshape the surface just enough to reduce astigmatism during the same procedure. Depending on how much astigmatism you have and the health of your cornea, your surgeon may recommend a toric lens, femtosecond laser astigmatism correction, or a combination of both. This is measured and planned at your exam, not decided from a chart online.
What if some astigmatism is left after surgery?
Eyes are not perfectly predictable, and it is possible to have a small amount of astigmatism left over once your eye has healed. This is common and usually easy to address. Options include a light pair of glasses, a LASIK or PRK touch-up to sharpen the result, or, if you chose the Light Adjustable Lens, a series of quick in-office light treatments that let your surgeon fine-tune your vision after surgery. Because the Light Adjustable Lens is adjusted based on how you actually see rather than a prediction made beforehand, some patients with astigmatism find it an appealing choice.
You may also have read the question of whether surgery can make astigmatism worse. Any eye surgery uses small incisions, and in some cases those can shift the cornea’s shape by a small amount. Careful measurement and planning are meant to account for this, and if a little astigmatism does remain, the options above can bring your vision back into focus.
Does insurance or Medicare cover it?
Medicare and most insurance plans cover the standard cataract operation with a basic lens. Correcting astigmatism with a toric lens or a laser treatment is usually a premium upgrade you pay for out of pocket, because it goes beyond what insurance considers medically necessary.
At SuraVision, premium lens upgrades start at $2,500 per eye. You get the exact number in writing at your consultation, with no moving quote and no pressure. If you are weighing your choices, our cataract lens options page and your consultation both spell out your choices clearly.
How SuraVision plans your astigmatism correction
The plan starts with measurement. Your surgeon maps the shape of your cornea, measures how much astigmatism you have and in which direction, and reviews the overall health of your eye. From there, you and Dr. Sura talk through whether a toric lens, laser treatment, or a combination fits your eyes and your daily life.
At SuraVision, the same surgeon who plans your procedure performs it and follows your healing, all at one office. You can learn more on our cataract surgery in Houston page. If you are not yet sure whether cataracts are behind your blurry vision, our quick cataract self test is a simple place to start.
Frequently Asked Questions
Does cataract surgery correct astigmatism?
Yes, in most cases it can. Cataract surgery replaces your cloudy lens with a clear artificial one, and that same surgery can be planned to reduce astigmatism. This is usually done with a toric lens built to correct astigmatism, a laser treatment on the cornea, or both. Your surgeon measures your astigmatism ahead of time and chooses the approach that fits your eyes.
Can cataract surgery make astigmatism worse?
Any eye surgery involves small incisions, and in some cases those can change the cornea’s shape by a small amount. Careful measurements and planning are meant to account for this. If a little astigmatism is left over, it can often be corrected with glasses, a laser touch-up, or fine-tuning if you have a Light Adjustable Lens. Ask your surgeon what to expect for your eyes.
How is astigmatism corrected during cataract surgery?
There are two main ways. A toric lens implant has astigmatism correction built into the lens itself. A femtosecond laser can also make precise corneal treatments to reduce astigmatism during the same procedure. Sometimes a combination works best. Which one suits you depends on how much astigmatism you have and the health of your cornea, which your surgeon reviews at your exam.
Does Medicare pay for cataract surgery with astigmatism?
Medicare and most insurance plans cover the standard cataract operation with a basic lens. Correcting astigmatism with a toric lens or a laser treatment is usually a premium upgrade you pay for out of pocket, because it goes beyond what insurance considers medically necessary. At SuraVision, premium lens upgrades start at $2,500 per eye, and you get the exact cost in writing at your consultation.
Can astigmatism be corrected after cataract surgery?
Yes. If some astigmatism remains once your eye has healed, options include glasses, a LASIK or PRK touch-up, or, if you chose the Light Adjustable Lens, in-office light treatments that fine-tune your vision after surgery. Your surgeon can walk you through which of these fits your situation.
Talk through your options in Houston
If you have astigmatism and cataracts, the best way to know your options is a full exam and a conversation. Schedule a consultation with SuraVision to plan your cataract surgery and find out whether a toric lens, laser astigmatism correction, or the Light Adjustable Lens fits your eyes. Call 713-730-2020 or book online.