Hi Ashley
Yes, indeed astigmatism can be fixed during cataract surgery. Cataract surgery is nowadays a form of refractive surgery, where we take the opportunity to correct longsight, shortsight as well as astigmatism at the same time.
Taking a step back, longsight, shortsight and astigmatism are all 'refractive errors' or focusing issues of the eye. When surgeons perform cataract surgery, we are removing an old hazy lens and replacing it with a new one. This new lens can be customised to the particular patients' eye so that we can provide a post-operative spectacle power desired by the patient.
In an eye, there are mainly 2 parts that focus light-the cornea and the lens.
Astigmatism usually arises from an irregularity of the shape of the cornea, and to a lesser extent the lens. The irregularity is because in one direction, there is a more curved or rounder surface, and in the other direction, there is a flatter surface. Kind of like a rugby ball.
Since we remove the lens (which is the cataract) during surgery, the only source of astigmatism remaining afterwards would be the cornea. Therefore, to reduce astigmatism after surgery, we can choose a new 'toric' lens implant that will cancel out the astigmatism of the cornea.
Low degrees of corneal astigmatism less than about 50-75 degrees do not need correcting usually, because it does not blur vision much at all. Higher degrees can be corrected very well with the special toric lens implants.
Other methods that can be used to reduce or correct astigmatism include special cuts on the cornea called relaxing incisions, but these are rarely used nowadays because they are much less accurate than toric lens implants.
Laser surgeries such as LASIK are also possible to correct astigmatism but in the context of cataract surgery, can only be done once the eye has healed from the original cataract surgery, about 3 months after the original operation.
