Post-LASIK Astigmatism: Is It Normal to Increase?

Q: Post-LASIK Astigmatism: Is It Normal to Increase?

Hello： It may just be a temporary symptom, and there could be changes before it stabilizes completely. <br>Whether it will return to normal is something that should be discussed with the attending physician.

Postoperative care after myopia laser surgery?

I had LASIK on February 11th, and the doctor said my vision is now 20/20, but I have astigmatism of about 150 degrees in both eyes, whereas before the surgery, it was only around 50 degrees.
Why has the astigmatism increased post-surgery? Is this normal, or is it just a temporary side effect that will return to normal later? Since laser vision correction should be able to correct both myopia and astigmatism, I am concerned.

Niming, 20~29 year old female. Ask Date: 2022/03/03

Dr. Gao Pilin reply Ophthalmology

Hello: It may just be a temporary symptom, and there could be changes before it stabilizes completely.
Whether it will return to normal is something that should be discussed with the attending physician.

Reply Date: 2022/03/03

More Info

Post-LASIK astigmatism can indeed be a concern for many patients, especially when they notice an increase in astigmatism after undergoing the procedure. To understand this phenomenon, it's essential to consider the mechanics of LASIK surgery and the healing process that follows.

Firstly, LASIK (Laser-Assisted In Situ Keratomileusis) is designed to reshape the cornea to correct refractive errors, including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. The goal is to create a more uniform corneal surface, which should ideally reduce or eliminate astigmatism. However, there are several factors that can contribute to an increase in astigmatism post-surgery.

1. Healing Process: After LASIK, the cornea undergoes a healing process that can take several weeks to months. During this time, the cornea may swell or change shape temporarily, which can lead to fluctuations in vision quality, including an increase in astigmatism. This is often a normal part of the recovery process, and many patients experience improvements as their eyes heal.

2. Corneal Flap Issues: LASIK involves creating a flap in the cornea, and if this flap does not settle properly or if there are irregularities in the healing of the flap, it can lead to changes in corneal shape, resulting in astigmatism. This can sometimes be addressed with additional treatments, such as enhancement procedures, if necessary.

3. Overcorrection or Undercorrection: In some cases, the laser may overcorrect or undercorrect the astigmatism during the procedure. If the initial measurements were not accurate or if the corneal response to the laser was unexpected, this could lead to a higher degree of astigmatism post-surgery.

4. Pre-existing Conditions: Some patients may have pre-existing conditions that were not fully addressed before surgery. For example, if there was a subtle irregularity in the cornea that was not detected preoperatively, it may become more pronounced after LASIK.

5. Postoperative Complications: Although rare, complications such as corneal ectasia (a progressive thinning and bulging of the cornea) can occur after LASIK, leading to increased astigmatism. This condition requires careful monitoring and may necessitate further intervention.

Regarding your specific situation, where you had a preoperative astigmatism of 50 degrees and now have 150 degrees post-surgery, it is essential to follow up with your ophthalmologist. They can conduct a thorough examination to determine the cause of the increased astigmatism and assess whether it is a temporary issue related to the healing process or something that may require further treatment.

In many cases, patients find that their vision stabilizes and improves over time as the cornea heals. However, if the astigmatism persists or worsens, your doctor may discuss options for enhancement procedures or other corrective measures.

In summary, while an increase in astigmatism after LASIK can be concerning, it is not uncommon. The healing process, flap issues, and potential overcorrection are all factors that can contribute to this change. Regular follow-up with your eye care provider is crucial to monitor your recovery and address any ongoing concerns.

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