Can Laser Eye Surgery Fix Astigmatism? Yes, Very Accurately

Yes. Astigmatism is one of the things laser eye surgery corrects best, and with today’s technology it’s corrected very accurately, with results that last. Here’s how, in a few minutes’ reading.

What astigmatism is

A normal cornea is curved like a football cut in half: the same in every direction. An astigmatic cornea is curved more steeply in one direction than the other, like the back of a spoon. Light entering it focuses at two points instead of one, and you see blur, ghosting or smeared edges, especially at night. Glasses and contact lenses correct the blur by bending light to compensate. They don’t change the cornea.

How the laser fixes it

Laser eye surgery removes a precisely calculated, microscopically thin layer of corneal tissue, more along the steep axis than the flat one, until the curve is the same in every direction. The cause of the astigmatism is gone, not compensated for. LASIK and PRK both do this with the same laser; the difference between them is how the surface is handled, not how well the astigmatism is treated.

Why ray tracing makes it so accurate

The hard part of treating astigmatism has never been the laser. It’s knowing exactly how much to treat and on exactly which axis. Traditional planning starts with the glasses test, “which is better, one or two?”, which is subjective and has a margin of error built in.

WaveLight Plus ray tracing removes that step. A single scan measures your whole eye, front and back surface of the cornea, the lens and the length of the eye, and builds a three-dimensional virtual model of it. The treatment is then calculated by tracing light rays through that model until they focus perfectly, and applied to the cornea exactly as calculated. Nothing depends on how you answered at the phoropter.

The evidence backs it up. In a randomised, double-blinded trial published in the journal Ophthalmology in 2025, patients had one eye treated with WaveLight Plus and the other with standard wavefront-optimised LASIK. Every WaveLight Plus eye saw 20/20 or better without glasses, against 93% of the standard eyes, and 83% saw 20/16 or better, against 73%. Refractive accuracy was slightly higher too.

I perform ray-tracing-guided LASIK at Focus Vision, which has the only WaveLight Plus system in Queensland.

Do the results last?

Yes. In a two-year series of eyes treated with WaveLight Plus ray tracing, every eye saw 20/20 or better without glasses at two years, none lost a line of best vision and 65% gained one, 95% were within half a dioptre of the target and about 85% had half a dioptre or less of astigmatism remaining. The cornea doesn’t drift back. Your eyes still age, and reading glasses arrive in your forties for everyone, but the astigmatism correction holds.

Who it suits

Most people with astigmatism and a stable prescription are candidates. Three things decide it, and all three come from the scans at your assessment rather than from the astigmatism itself:

• A healthy, strong cornea. I measure corneal strength directly, with Corvis biomechanics and the TBI score, and won’t do laser on a cornea that can’t take it.
• Regular astigmatism. Irregular astigmatism from keratoconus is a different condition. It’s treated with cross-linking and CAIRS, not laser, and it’s most of what I do.
• A prescription in range. Very high prescriptions are better served by an implantable lens or refractive lens exchange, which correct astigmatism just as well.

The assessment at Focus Vision is free, takes about an hour, and tells you which of these applies to you. Costs are the same whether or not you have astigmatism. If you’d rather start online, the suitability test takes two minutes.