Correcting Astigmatism during Cataract Surgery - SightMD Skip to main content

Cataract Surgery and Astigmatism

There are several ways to correct astigmatism in the setting of cataract surgery. Our eye surgeons are ready to assist our patients in reduction or elimination of astigmatism.

What is Astigmatism

Astigmatism is a condition that prevents the eye from consistently focusing light in all directions. This highly common condition is induced by an abnormal curvature of the lens or the eye itself, resulting in more of a football shape instead of a baseball. Astigmatism can affect your near and distance vision, often causing mild blurring or double vision. Our doctors are able to determine the amount of astigmatism affecting your vision during your cataract evaluation.

Does Cataract Surgery Correct Astigmatism?

If you have astigmatism, it can now be corrected during your advanced laser cataract procedure. Depending on the amount of astigmatism you have, we may use the laser during cataract surgery to reshape it and correct astigmatism. These incisions can be made more precisely with a laser compared to a manual procedure. Correcting your astigmatism can help restore your vision to its full potential and may reduce your need for glasses or contact lenses.

Diagram comparing the light refraction of a normal eye and an eye with astigmatism

Surgical Options for Astigmatism in Cataract Surgery

The technique for the cataract removal and astigmatism correction will vary from patient to patient, but usually it is a simple procedure that may even eliminate the need for eyeglasses. Cataract surgery is an outpatient surgery that can take less than 20 minutes, and astigmatism correction adds a few minutes. After about two hours in the surgery center you will rest at home for the rest of the day. Recovery from cataract surgery with astigmatism occurs fairly quickly, but patients are encouraged to wait about a week before resuming normal activities. A few weeks after surgery, a follow-up appointment is necessary to evaluate the new eyeglass prescription, if needed.

There are currently three good choices to reduce or eliminate astigmatism in cataract surgery, leaving a patient with clearer vision without glasses or contact lenses

Limbal Relaxing Incisions

At the time of cataract surgery, our board certified cataract experts can perform limbal relaxing incisions that correct a moderate amount of astigmatism. We use computer programs to attempt precision corrections of smaller amounts of astigmatism. At the time of surgery, our eye doctors will simply make small relaxing incisions in the cornea to reduce or eliminate astigmatism. Limbal relaxing incisions work well, but if patients have larger degrees of astigmatism, limbal relaxing incisions are not powerful enough.

TORIC® Intraocular Implant

For patients with higher amounts of astigmatism, a TORIC® Intraocular Lens can precisely reduce astigmatism. The toric lens is considered one of the best cataract lens for astigmatism. A Toric implant is a premium implant that corrects astigmatism. Instead of correcting astigmatism in the corneal plane like limbal relaxing incisions, these specialty lens implants correct astigmatism at the lens plane. Typically patients have to pay extra for this implant, but in our experience, these patients tend to be highly satisfied with the results. We also offer zero percent financing for two years to make payment less of a burden.


After cataract surgery, our eye surgeons can perform LASIK to reduce or eliminate astigmatism. At times, a limbal relaxing incision or a TORIC® implant can leave a small amount of residual astigmatism. We typically eliminate the residual astigmatism with laser vision correction or LASIK. Patients feel comfortable that if they are left with a small amount of astigmatism, there is a safe, precise and effective method to finish the job. If a patient elects to have a standard intraocular lens and later decides that astigmatism reduction is something that they desire, LASIK is then used to eliminate it. We perform only the best in LASIK, iLASIK which is bladeless custom LASIK. Our LASIK platform uses a custom map of each patient’s unique visual system for the best results possible.

Does Insurance pay for Cataract Surgery with Astigmatism?

Insurance pays the same amount toward cataract surgery whether a surgeon conducts it with or without a laser. However, laser surgery has a higher cost and is used for those who have astigmatism and need a premium lens implant. That being said you will have to pay the difference between the covered amount and the additional costs of laser cataract surgery to fix astigmatism. Insurance may not cover all types of IOL so it is important to see what is covered before you decide to have astigmatism fixed. Insurance also does not pay for procedures exclusive to the implantation of these more advanced lenses that a surgeon would not perform for a traditional monofocal lens.

Can Astigmatism Develop after Cataract Surgery?

Most patients’ refractive astigmatism increases after cataract surgery. Performing cataract surgery alone actually worsens the astigmatic state of most patients. Large incisions and sutures can cause unwanted changes to the natural corneal shape. Thus, large incision cataract surgery usually worsens corneal astigmatism, and represents another advantage of sutureless, small incision techniques. Unlike eyeglasses, standard intraocular lens implants do not correct astigmatism. Because they are placed inside the eye, they do not alter or improve the shape of the cornea.

Can Astigmatism be Corrected After Cataract Surgery?

It is possible to reduce astigmatism by making small incisions in the outer surface of the cornea. This technique is called “astigmatic keratotomy”, and it is actually more effective the older the patient is. The incisions must be placed in a precise location in order to reduce the undesirable oblong shape of the cornea. Varying the length, depth, and location of the incisions determines how much of an effect they have. Unlike a cataract incision, these incisions are only partial thickness. Special, expensive surgical blades made from diamonds are used. Astigmatic keratotomy can be done at the same time as cataract surgery, because these incisions do not weaken the eye, or prolong the surgical or recovery time.

If you are interested in cataract surgery with astigmatism correction Contact SightMD today to schedule an appointment with one of our doctors to discuss your options.