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- Can Astigmatism Be Lasered? Laser Eye Surgery for Astigmatism Explained
Can Astigmatism Be Lasered? Laser Eye Surgery for Astigmatism Explained
Yes. Laser eye surgery for astigmatism is routine: the laser reshapes the cornea so its uneven curves focus light at one point, in the same treatment as short or long sight. The Royal College of Ophthalmologists gives up to ±6.00 dioptres of astigmatism as the usual laser range. Irregular astigmatism, keratoconus and thin corneas are not suitable. At Laser Istanbul Clinic, Prof. Dr. Ahmet Satıcı or Op. Dr. Aysan Bayram decides after scanning your corneas.
Can you have laser eye surgery if you have astigmatism?
Yes, in most adults with regular astigmatism and healthy corneas. Astigmatism means the cornea (the clear front window of the eye) is shaped more like a rugby ball than a football, so light is focused at more than one place and vision blurs. The NHS lists laser eye or lens surgery as a possible permanent treatment, alongside glasses and contact lenses.
Laser works because astigmatism is a shape problem, and a laser changes shape. The Royal College of Ophthalmologists (RCOphth) explains that modern surgical lasers alter the curvature and focusing power of the cornea very accurately to correct short sight, long sight and astigmatism. The American Academy of Ophthalmology (AAO) says the same of LASIK. Your astigmatism is not a separate operation: it is built into the treatment plan for the rest of your prescription, and the whole procedure typically takes about half an hour for both eyes.
So if you are asking "can I get laser eye surgery with astigmatism?", the answer depends on three things your surgeon measures rather than guesses:
- How much astigmatism you have (the cylinder, or CYL, number on your glasses prescription).
- What kind of astigmatism it is (regular or irregular).
- Whether your corneas are healthy, thick enough and stable.
How much astigmatism can laser eye surgery correct?
Up to about ±6.00 dioptres (D) of astigmatism is the usual range for laser vision correction. The RCOphth lists the prescriptions most likely to suit laser as up to −10.00 D of short sight, up to +4.00 D of long sight and up to ±6.00 D of astigmatism. It adds that laser can work for higher prescriptions in some patients, while some people with lower prescriptions are better suited to lens implants.
A dioptre is the unit of lens power on your glasses prescription. Most prescriptions show three numbers: sphere (short or long sight), cylinder (astigmatism) and axis (the direction of the astigmatism, from 0 to 180).
Approved ranges differ between laser platforms. EyeWiki, the AAO's clinical encyclopaedia, gives examples of laser approvals that run up to −6.00 D of astigmatism on some platforms and up to −3.00 D on others, so your surgeon checks the range for the specific laser used.
How accurate is it? A systematic review summarised by EyeWiki found that a median of 92% of eyes treated with LASIK for short sight or short-sighted astigmatism were within 1.00 D of the intended correction. Results are less predictable at the top of the range, which is why very high astigmatism is often better treated another way.
| Your astigmatism | What usually happens |
|---|---|
| Low to moderate, regular (within about ±6.00 D) | Laser is usually suitable if corneas are healthy and thick enough |
| High, or combined with a very high prescription | Laser may still work in some patients; a toric ICL (implantable lens) is often more predictable |
| Irregular (uneven curves, scarring, keratoconus) | Standard laser is not suitable; specialist corneal care instead |
| Over about 45–50, or with early cataract | Lens replacement with a toric lens is often a better choice than laser |
"Toric" means the lens has astigmatism correction built in.
Which astigmatism can't be lasered?
Irregular astigmatism cannot be treated with standard laser eye surgery. Regular astigmatism has two main curves at right angles to each other, which a laser can even out. In irregular astigmatism the curves are uneven or not at right angles, often because of keratoconus, corneal scarring or earlier surgery. Reshaping a cornea that is already weak or distorted would risk making it worse.
This matters because astigmatism can be linked to keratoconus, a condition in which the cornea thins and bulges, as the NHS notes, which is one reason regular eye tests matter. The AAO lists extreme astigmatism, thin corneas and certain eye diseases among the reasons a person is not a good candidate for LASIK.
Astigmatism that keeps increasing from year to year, especially in teenagers and young adults, deserves a corneal scan before anyone discusses surgery. If your scans suggest irregular astigmatism or keratoconus, Doç. Dr. Muhammet Derda Özer, our cornea specialist, reviews your case. ("Doç." is the Turkish title for Associate Professor; he speaks Turkish and English.) Treatment may then involve rigid contact lenses or corneal cross-linking, a procedure that strengthens a weak cornea, rather than laser.
You are also less likely to be suitable if you have cataract, problems with the health of the eye surface such as severe dry eye, or a prescription that has not stayed stable.
LASIK, SMILE or PRK: which laser is best for astigmatism?
All three main laser methods treat astigmatism, and the RCOphth says visual results at three months are equally good for all types of laser vision correction. The differences are recovery, comfort and which corneas each suits.
| LASIK / Femto-LASIK | SMILE / SMILE Pro | PRK and surface laser (incl. no-touch) | |
|---|---|---|---|
| How it works | A thin flap is lifted and the cornea underneath is reshaped | A lens-shaped piece of tissue is removed through a small incision, no flap | The thin surface layer is removed, then the cornea is reshaped |
| Visual recovery | Fastest: many people are back at work the next day (RCOphth) | May be slightly slower than LASIK | A week or longer before the driving standard (RCOphth) |
| Early comfort | Mild surface discomfort | Eye-surface comfort may recover slightly faster | The eye is normally very sore while the surface layer regrows |
| Astigmatism notes | Eye tracking and iris registration help align the treatment | A tendency to slight under-correction of low to moderate astigmatism has been reported; re-treatment may need a surface laser | Often chosen for thinner corneas |
Alignment matters particularly for astigmatism, because it has a direction. EyeWiki notes that the eye can rotate by about 2–4 degrees between sitting up and lying down for surgery, and describes eye-tracking and iris-registration technology that corrects this "cyclotorsion". The VisuMax 800 laser used for SMILE Pro has a dedicated assistant for it. This is one reason your surgeon measures your eyes sitting up before treatment.
Prof. Dr. Satıcı or Op. Dr. Bayram chooses the method after your scans. For a full comparison, read our guide:
How is your suitability for astigmatism laser checked?
Your surgeon decides whether your astigmatism can be lasered from measurements, not from your prescription alone.
You are most likely to be suitable if you:
- are over 18 (the AAO prefers over 21) and have a stable prescription, which the RCOphth defines as no change greater than 0.5 D in the last two years
- have regular astigmatism within the laser range
- have healthy corneas of adequate thickness and no eye disease
- have realistic expectations (the AAO lists this as a requirement)
The pre-operative examination typically includes:
- A full refraction, with and without dilating drops, to measure your sphere, cylinder and axis.
- Corneal topography or tomography, a 3D map of the cornea that shows whether the astigmatism is regular and screens for keratoconus.
- Corneal thickness (pachymetry), which sets how much tissue can safely be treated.
- A dry-eye and tear-film check, because dry eye is the most common side effect of laser.
- A retina check, especially for people with a strong prescription.
Contact lenses can temporarily change the shape of your cornea, so you leave them out before your examination so that the measurements reflect your natural eye. Your coordinator confirms how long for your type of lens: {{contact-lens break before the pre-op exam: soft / toric / rigid lenses}}.
Laser eye surgery for astigmatism: pros and cons
Laser for astigmatism has clear benefits and real risks. Both belong in your decision.
| Pros | Cons |
|---|---|
| High satisfaction. The RCOphth reports that over 95% of patients are satisfied with the outcome | Not for everyone. Irregular astigmatism, keratoconus, thin corneas and unstable prescriptions rule it out |
| Less dependence on glasses and contact lenses. About 90% of patients reach 20/20 to 20/40 vision without correction after LASIK (AAO) | Reading glasses may still be needed. Laser does not stop age-related loss of near focus (presbyopia) |
| Quick procedure. About half an hour for both eyes, same-day return home (RCOphth) | Dry eye is common at first. It usually settles within a few months (RCOphth) |
| Fast recovery after LASIK. Patients are often back at work the day after (RCOphth) | Glare, halos and starbursts at night. Usually mild and improving within a few months with modern lasers; lasting problems are unusual but possible (RCOphth) |
| Gym and jogging from day one; swimming after about a week (RCOphth) | Under- or over-correction is possible. Up to 1 in 10 patients need some additional surgery to get the best result (RCOphth) |
| Often better comfort than contact lenses for people whose lenses irritate their eyes (RCOphth) | Serious complications are rare but real. Fewer than 1 in 5,000 patients need a corneal transplant after laser surgery (RCOphth) |
| Permanent reshaping of the cornea (see below) | Not available on the NHS. It is elective surgery that you pay for privately (NHS) |
Dry eye and astigmatism. The RCOphth notes that for patients with a normal eye surface before surgery, lasting problems are unusual. Your surgeon tests your tear film beforehand and may treat dry eye first or choose a different method.
How long does laser eye surgery last for astigmatism?
The reshaping of the cornea is permanent, but your eyes can still change over time. The laser removes tissue that does not grow back, so the astigmatism it corrected does not simply return. However, the RCOphth explains that short sight and astigmatism normally stabilise in the late teens or early 20s, and that natural prescription changes can occur at any stage in life, so laser vision correction sometimes needs to be repeated. The AAO likewise says that astigmatism can change gradually over time and may worsen, improve or stay stable.
What this means in practice:
- The correction holds for most people. EyeWiki reports an 18-year audit in which the retreatment rate was 2.55% across all myopic cases, and refractive stability data in which 99.4% of eyes changed by 1.00 D or less between 1 and 3 months.
- Some people need a touch-up. If some astigmatism remains or returns, an enhancement is often possible when enough corneal thickness remains. After SMILE, re-treatment may need a surface laser (PRK), according to EyeWiki.
- Your eyes keep ageing. Laser does not stop presbyopia, and cataracts can develop later in life. The RCOphth says laser can slightly reduce the accuracy of lens calculations in future cataract surgery, so tell your cataract surgeon that you have had laser. A toric lens can then correct astigmatism again if needed.
- A stable prescription comes first. This is why surgeons ask for evidence that your prescription has not changed, and why laser is not offered to young people whose eyes are still changing.
Your surgeon explains your own outlook and any touch-up policy in writing: {{enhancement and re-treatment policy: whether and for how long touch-ups are included}}.
What are the risks of laser eye surgery for astigmatism?
The risks are the same as for laser eye surgery in general. The main ones are:
- Dry eye and fluctuating vision. Common, and usually settling within a few months (RCOphth).
- Glare, halos, starbursts and ghost images at night, especially after treatment of higher prescriptions. Usually mild and improving within a few months with modern lasers (RCOphth).
- Residual astigmatism or over-correction, sometimes needing an enhancement.
- Corneal ectasia (an unstable, bulging cornea) and scarring after infection or abnormal healing, which are infrequent but can in the worst case lead to a corneal transplant (fewer than 1 in 5,000 patients, RCOphth).
Do not drive until your surgeon confirms that your vision meets the driving standard. Contact your surgeon without delay if you have increasing pain, light sensitivity, redness or blur (RCOphth). Your surgeon explains your personal risks in writing, through your interpreter, before you sign anything.
What if laser isn't right for your astigmatism?
If laser is not suitable, there are other ways to correct astigmatism, some of them permanent.
| Option | How it corrects astigmatism | Usually suits |
|---|---|---|
| Glasses | A lens with extra power in one direction cancels the uneven curve | Everyone; the NHS calls them the cheapest option |
| Toric soft or rigid (RGP) contact lenses | Toric lenses stay aligned on the eye; rigid lenses create a smooth new front surface | Regular astigmatism (toric); the AAO says rigid lenses may work best for severe or irregular astigmatism |
| Toric ICL (implantable lens) | A lens with built-in astigmatism correction sits inside the eye in front of the natural lens; it can be removed | Short sight with astigmatism, thin corneas or high prescriptions. In the US it is indicated for 1.0–4.0 D of astigmatism, ages 21–45 (EyeWiki) |
| Toric lens replacement | The natural lens is replaced with a toric artificial lens | Usually over about 45–50, or with cataract. EyeWiki gives 0.75–4.75 D of correction at the corneal plane |
| Corneal cross-linking | Strengthens a weak cornea; it does not remove astigmatism | Progressive keratoconus |
Prof. Dr. Satıcı performs laser, ICL and lens surgery, so he can compare these options for your eyes honestly. Op. Dr. Bayram treats astigmatism with laser and with toric lenses in cataract surgery.
What happens at Laser Istanbul Clinic?
Free online assessment
Send your glasses prescription (including the CYL and AXIS values) and any eye reports. A surgeon tells you which treatment is likely to suit you.
Full examination in Istanbul
The tests above, with your surgeon and a personal interpreter. If laser is not right for you, your surgeon says so and explains the alternatives.
Treatment day
Numbing drops are used and a small clip holds your eyelids open. You look at a target light while the laser works, and you return to your hotel the same day.
Checks and home
Plan 3–5 days in Istanbul for Femto-LASIK or SMILE Pro; surface treatments and lens surgery usually need a few more days. Most patients can fly 1–3 days after LASIK or SMILE, once their surgeon has checked their eyes. Your coordinator stays in touch and your surgeon reviews your progress remotely, by video.
Your treatment price includes the pre-operative examination and scans, surgery by your named surgeon, medication, follow-up checks in Istanbul, a personal interpreter, a coordinator and remote follow-up. Hotel and airport transfers are not included; they are a separate charge that we arrange on request, and flights are not included.
Surgery takes place in a fully equipped, Ministry of Health–licensed operating theatre in Istanbul.
Frequently asked questions
Yes, if your astigmatism is regular, within the laser range (usually up to about ±6.00 D according to the Royal College of Ophthalmologists) and your corneas are healthy, thick enough and stable. Your surgeon confirms this with corneal scans. If your astigmatism is irregular or you have keratoconus, laser is not the right treatment.
Yes. Short sight, long sight and astigmatism are corrected together in one treatment, because the laser reshapes the same cornea. The sphere and cylinder from your prescription are both entered into the treatment plan, along with the axis.
Often yes. Each eye is measured and treated according to its own prescription, so one eye can be treated for astigmatism and short sight while the other needs less. Your surgeon plans both eyes together.
The RCOphth gives up to ±6.00 D as the usual range, but your surgeon also looks at your total prescription and corneal thickness, and approved ranges differ between laser platforms. With very high astigmatism or thin corneas, a toric ICL or toric lens replacement is often more predictable.
The corneal reshaping is permanent, but your eyes can still change over the years. The RCOphth explains that short sight and astigmatism normally stabilise in the late teens or early 20s, and natural prescription changes can occur at any age, so a second treatment is sometimes needed.
None is better for everyone: visual results at three months are equally good for all three (RCOphth). LASIK has the fastest recovery, SMILE has no flap but may under-correct a little in low to moderate astigmatism, and PRK suits thinner corneas but recovery is slower and sorer. Your surgeon recommends one after your scans.
Many people no longer need glasses for distance. The RCOphth notes that glasses may still be required for some activities, particularly reading in older patients, because laser does not treat age-related loss of near focus. If a small amount of astigmatism remains, an enhancement may be possible.
Laser is widely used, and over 95% of patients are satisfied with the outcome (RCOphth). No surgery is risk-free: dry eye, night glare and the need for further surgery in up to 1 in 10 patients are the more common issues, and serious permanent vision loss is rare. Your surgeon explains your personal risks in writing.
Wondering whether your astigmatism can be lasered?
Send us your glasses prescription and any eye reports. Prof. Dr. Ahmet Satıcı or Op. Dr. Aysan Bayram will tell you whether laser, a toric ICL or a toric lens is likely to suit your eyes, and will say so honestly if laser is not right for you.
Sources for the facts on this page
- All opened and checked on 7 Oct 2026.
- The Royal College of Ophthalmologists. Laser Vision Correction: patient information (PROF/2024/499). Suitability, prescription ranges, procedure types, risks, side effects, re-treatment. https://www.rcophth.ac.uk/guidance-resources/laser-vision-correction/ (PDF: https://www.rcophth.ac.uk/wp-content/uploads/2026/08/Laser-vision-correction-patient-information.pdf)
- NHS. Astigmatism. https://www.nhs.uk/conditions/astigmatism/
- National Eye Institute (NIH). Astigmatism. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/astigmatism
- American Academy of Ophthalmology. What Is Astigmatism? https://www.aao.org/eye-health/diseases/what-is-astigmatism
- American Academy of Ophthalmology. LASIK — Laser Eye Surgery. https://www.aao.org/eye-health/treatments/lasik
- EyeWiki (AAO). LASIK for Myopia and Astigmatism: Safety and Efficacy. https://eyewiki.org/LASIK_for_Myopia_and_Astigmatism:_Safety_and_Efficacy
- EyeWiki (AAO). Keratorefractive Lenticule Extraction (KLEx) Surgeries. https://eyewiki.org/Keratorefractive_Lenticule_Extraction_(KLEx)_Surgeries
- EyeWiki (AAO). Photorefractive Keratectomy. https://eyewiki.org/Photorefractive_Keratectomy
- EyeWiki (AAO). Implantable Collamer Lens. https://eyewiki.org/Implantable_Collamer_Lens
- EyeWiki (AAO). Astigmatism Correction at the Time of Cataract Surgery. https://eyewiki.org/Astigmatism_Correction_at_the_Time_of_Cataract_Surgery
- EyeWiki (AAO). Physiology of Astigmatism (cyclotorsion of about 2–4 degrees; cited via the clinic's English astigmatism page, content/en/astigmatism.md). https://eyewiki.org/Physiology_of_Astigmatism