Astigmatism is one of the most common refractive errors affecting vision, yet many people are unsure whether it can be corrected through refractive surgery. In Singapore, LASIK and implantable contact lens (ICL) surgery have made it possible for those suitable to significantly reduce or eliminate the use of glasses and contact lenses. But is surgery always the answer? In this article, we will discuss more abouton which option is best.
What is astigmatism, and how does it cause blurred or distorted vision?
Astigmatism occurs when the cornea (the front surface of the eye) has an irregular shape. The cornea should be round in shape, like a basketball. With astigmatism, the shape resembles a rugby ball, and this causes light to focus unevenly on the retina. As light rays do not converge at a single focal point, this causes the vision to be blurry or distorted at all distances. Visual disturbances include seeing shadows around objects, hard to read small print, or seeing more glare at night.
Astigmatism with myopia or hyperopia
Astigmatism often exists alongside myopia (short-sightedness) or hyperopia (long-sightedness). This combination can make vision correction less straightforward, as 2 types of refractive errors need to be addressed.
Why are glasses and contact lenses not the only options?
The most common solution is the use of glasses and toric contact lenses to correct astigmatism effectively, though they are not the only solution. Many people in Singapore seek refractive surgery, with the most common being LASIK surgery to reduce long-term dependence on corrective eyewear, especially those with active lifestyles seeking convenience.
Can refractive surgery treat astigmatism?
Short answer: Yes, in many suitable cases.
In Singapore, modern refractive surgery techniques are effective in treating astigmatism. Laser vision correction procedures like LASIK, Epi-LASIK, and SMILE can reshape the cornea to improve how light focuses on the retina.
Why the amount and type of astigmatism matter
The level of astigmatism prescription plays a key role in determining suitability. Mild to moderate astigmatism is typically easier to correct, while higher levels may require an alternative procedure like implantable contact lens surgery.
When may surgery reduce rather than fully eliminate spectacle use?
For those with very high levels of astigmatism, myopia, and hyperopia, surgery may significantly reduce dependence on glasses but not completely eliminate it. Enhancement procedures or occasional glasses use may still be needed.
Which refractive surgery options can fix astigmatism?
LASIK surgery
LASIK surgery in Singapore remains one of the most popular options for correcting astigmatism with a long history of proven efficacy.
How corneal reshaping works
LASIK starts with creating a thin corneal flap, which is then folded back. Thereafter, an excimer laser is used to reshape the tissue under the flap. The flap returns to its original position when lasering completes. This corrects the irregular curvature, allowing light to focus properly on the retina.
Common suitability criteria
You are typically suitable if:
- You have had a stable prescription in the past 12 months
- Your corneas are adequately thick
- You do not have existing eye conditions, including glaucoma, cataract, or corneal diseases
- You are 18 years old or above
A comprehensive 3-hour LASIK evaluation in Singapore is essential to ascertain eligibility for surgery.
Epi-LASIK surgery
Epi-LASIK surgery is a type of surface-based laser vision correction procedure that does not involve creating a corneal flap.
When do you consider surface ablation?
It is often recommended for those unsuitable for LASIK due to thinner corneas or irregularly shaped corneas.
Why surface ablation may suit some corneas better than LASIK?
As Epi-LASIK preserves more corneal tissue with less tissue removal, it can be safer for certain eye structures or those with thinner corneas. However, vision recovery tends to be slower, and the discomfort level post-surgery is higher compared to LASIK.
Other refractive options if laser vision correction is not ideal
For those unsuitable for laser vision correction, alternatives such as ICL surgery may be considered. This option does not reshape the cornea through tissue removal but instead adds a corrective lens inside the eye.
What if your astigmatism is too high or your cornea is unsuitable?
When LASIK may not be ideal:
LASIK may not be recommended if:
- The cornea is too thin
- Astigmatism is very high
- The cornea is irregularly shaped
Why ICL surgery may come into the discussion?
ICL surgery is a viable option for those with a high level of astigmatism or myopia. It aims to provide a high-quality vision correction without removing corneal tissue.
Importance of surgeon-led decision-making
Choosing the right procedure requires careful assessment by an experienced eye surgeon in Singapore. A personalised approach ensures both safety and optimal visual outcomes.
What if your astigmatism is too high or your cornea is unsuitable?
When LASIK may not be ideal:
LASIK may not be recommended if:
- The cornea is too thin
- Astigmatism is very high
- The cornea is irregularly shaped
Why ICL surgery may come into the discussion?
ICL surgery is a viable option for those with a high level of astigmatism or myopia. It aims to provide a high-quality vision correction without removing corneal tissue.
Importance of surgeon-led decision-making
Choosing the right procedure requires careful assessment by an experienced eye surgeon in Singapore. A personalised approach ensures both safety and optimal visual outcomes.
LASIK vs SMILE vs Epi-LASIK for astigmatism
Procedure differences
- LASIK: Flap-based, precise
- ReLEx SMILE No flap
- Epi-LASIK: Surface-based, no flap
Recovery time
- LASIK: Fast recovery (Next day)
- SMILE: Slightly longer than LASIK but still quick
- Epi-LASIK: Longer recovery (several days to weeks)
Dry eye considerations
All forms of laser vision correction may temporarily worsen dry eye symptoms. Comparatively, the incidence of dry eye is higher in LASIK compared to SMILE and Epi-LASIK, but that is mostly during the immediate post-op period. The eyes (whether it is LASIK, SMILE, or epi-LASIK) return to their pre-surgery state after 1 to 3 months.
Precision and stability
All 3 procedures offer good vision outcomes when performed on suitable eyes. Today’s laser technology is very mature and surgical accuracy has improved, particularly in treating astigmatism.
What happens during a LASIK evaluation in Singapore?
A comprehensive 3-hour LASIK evaluation in Singapore is the first important step prior to LASIK surgery.
Prescription testing
Our clinical optometrist will measure your visual acuity, level of eye prescription, pre- and post-pupil dilation.
Corneal topography and thickness checks
Imaging is performed to assess the corneal curvature and structure for conditions such as keratoconus (bulging cornea) and to measure the thickness of the cornea, ensuring it is safe and suitable for laser reshaping.
Why isn’t everyone suitable for laser vision correction?
Not all eyes are suitable for laser procedures. Conditions such as keratoconus, cataract, thin cornea, and unstable prescriptions may require alternative approaches.
How much does laser eye surgery cost in Singapore?
Why cost vary by procedure
LASIK surgery cost in Singapore does vary depending on the type of procedure, laser technology, and the surgeon’s expertise and experience.
LASIK vs SMILE vs surface ablation pricing factors
- LASIK: Generally more affordable than SMILE
- SMILE: Slightly higher due to being the youngest in the market
- Epi-LASIK: Comparable or slightly lower, depending on the provider
Evaluation fees and package structure
Most eye centres charge evaluation, surgery, medication, and post-op reviews separately. There may be some that offer bundled packages. It is hence important to clarify the fees and what is included when comparing laser eye surgery costs in Singapore. Cheapest does not always mean the best. It is prudent to read up more, hear from friends and family who have had the surgery, get recommended by your GP, or have a look at online reviews, as vision is precious, and you need to live with it for the rest of your life.
When should you consider refractive surgery for astigmatism?
If glasses no longer meet your lifestyle needs
Refractive surgery can offer freedom and convenience if you start to find glasses inconvenient for sports, work, or daily activities.
If you want to reduce dependence on contact lenses
Refractive surgery offers a more permanent solution, as long periods of contact lens use can lead to dryness, infection, or discomfort.
If your prescription has been stable
A stable prescription for at least the past 12 months is an important requirement before considering any form of refractive surgery.
Final thoughts
Refractive surgery has transformed the way astigmatism is treated in Singapore. Whether it is through epi-LASK or LASIK surgery in Singapore or ReLEx SMILE surgery in Singapore, many people have achieved clearer vision with reduced reliance on contact lenses and glasses.
It needs to be noted that not every eye is the same. A thorough LASIK assessment at a reputable eye clinic, evaluated by an experienced eye care specialist or eye surgeon at our Mount Elizabeth Novena location, is imperative to determine the most suitable treatment.
Ultimately, you will choose the best possible surgical option that is personalised to your eyes, hobbies, profession, and expectations – ensuring both safety and long-term visual satisfaction.
If you like to take the first step to enjoy more convenience and freedom from glasses and contact lenses, please contact Lang Eye Centre at +65 6684 1000 or [email protected] for an evaluation to ascertain your refractive surgery options.
