During cataract surgery, it is indeed possible to correct astigmatism at the same time. The astigmatism correctable is the astigmatism that arises from the cornea, and this may be different from what you actually wear in your glasses or contacts.
There are a few ways astigmatism can be corrected at the setting of a cataract surgery:
1) Sometimes, if the astigmatism power is low and astigmatism's direction is where the small incision for cataract surgery is, nothing else needs to be done. The usual cataract incision can already treat the low astigmatism.
2) Choosing a lens implant (IOL) that incorporates astigmatism treatment: these are called toric IOLs. This can be in the form of either a monofocal or multifocal IOL.
To determine whether your astigmatism can be satisfactorily corrected by an IOL, you can undergo a careful test of your cornea curvature while measuring for the IOL, such as using a device (like the Galilei G6 which I first introduced in Singapore in 2016). This will show if your astigmatism is regular or irregular. Correction of regular astigmatism with IOL is more predictable than correction of irregular astigmatism with IOL.
3) Many years ago, before the toric IOL became available, eye surgeons including myself used a precise blade (a diamond blade) to make cuts on the sides of the cornea in a procedure called "LRI" (limbal relaxing incision) to treat astigmatism during cataract surgery. This has become less popular compared to the toric IOL as the LRI is less predictable and patients may get longer periods of side effects like dry eyes and irritation after surgery.
Having said all that, I had also treated patients who did not manage to get their astigmatism treated at the time of cataract surgery, due to reasons such as not being able to afford the more expensive IOL. Laser vision correction such as LASIK, advanced surface ablation and also RELEX SMILE can certainly treat low to moderate astigmatism very well, as a separate procedure. This can be done several months after the cataract surgery.
High astigmatism such as above 300 degree, however, is best corrected by toric IOL.
I wish you a successful cataract surgery!
Cheerio
Dr Daphne Han
