Can People with Astigmatism Undergo SMILE LASIK?

Can People with Astigmatism Undergo SMILE LASIK?


Astigmatism with a certain level of myopia can be corrected with SMILE LASIK. In contrast, in cases of hyperopia combined with astigmatism, correction with SMILE may not be possible. The majority of people with astigmatism can be corrected with SMILE.


However, SMILE May not be Suitable for Those with Only Astigmatism as Follows:


LASIK and LASEK correct vision by ablating the cornea, and even a small amount of ablation can achieve correction. However, SMILE does not remove tissue by burning it away. Instead, it separates a layer within the cornea and removes it manually. For this method, a certain amount of tissue volume is required, so a certain degree of myopia is needed to allow proper separation and handling of the lenticule. Therefore, SMILE is generally only possible when a sufficient amount of myopia is present.


What If You Have High Astigmatism but Want SMILE LASIK?



High astigmatism can place certain limitations on SMILE LASIK, as the system allows for correction up to -10 diopters of myopia and -5 diopters of astigmatism. Astigmatism over -5 diopters is relatively rare. However, in cases of very high astigmatism, some residual astigmatism may remain even after maximum correction with SMILE.


That said, no one has absolutely zero astigmatism — we all have a small amount, though it often goes unnoticed. While even slight myopia can noticeably affect vision, mild astigmatism typically causes little to no discomfort. Therefore, most levels of astigmatism can be effectively corrected with SMILE LASIK, and any slight remaining astigmatism usually does not cause significant issues.


What Are the Alternatives to SMILE LASIK for Correcting Astigmatism?



When SMILE LASIK alone cannot fully correct astigmatism, there are a few alternative methods.


One approach involves making corneal incisions, which can help reduce astigmatism. In some cases, this is followed by a second correction procedure 3 to 6 months later, once the astigmatism has decreased. This method is known as corneal relaxing incisions.


However, this technique is not commonly used because making incisions in a highly astigmatic cornea can result in irregular reduction, which may worsen visual quality. 


Instead of relying on corneal incisions, a more common and modern approach is to reduce as much astigmatism as possible with SMILE, then use LASEK afterward to correct any remaining astigmatism.



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