Patients with large amounts of astigmatism are some of the happiest LASIK patients that I treat. My wife had about 5 diopters of astigmatism when I treated her 12+ years ago. The treatment has dramatically changed her life. Patients with astigmatism see well only through the optical center of their glasses and when they move their eyes behind the lens, images become blurry. The same person wearing contact lenses has blurry vision every time that they blink. When the correction is placed directly on the cornea, the quality and quantity of vision can be improved. I receive great hugs from my high astigmatism patients. Those with extreme amounts of astigmatism may require more than one treatment to achieve the desired result.
LASIK is great for astigmatism and can even sometimes correct types of astigmatism that glasses or contacts cannot.
If you have a low to moderate amount of astigmatism, either LASIK or LASEK can successfully eliminate that. I know this personally as both a surgeon and patient, as I had 1.50 diopters of astigmatism before my LASIK in 1999, and got rid of it totally (although I needed to be "double-carded" or my myopia shot first, then another treatment card inserted into the laser to treat my astigmatism, because this was so long ago it was before FDA approved the COMBINED treatment of myopia PLUS astigmatism ALL AT ONCE. HOWEVER, if you have EXTREME astigmatism, like more than 3 diopters, LASEK works better, because there is no flap, which does not actually conform correctly to the underlying bed. The laser in ALL procedures works by evaporating corneal tissue; thereby changing it's shape. You can imagine if you change the shape of the bed (the part under the flap) and make it round, like a basketball, instead of oval like a football, AND THEN PUT BACK THE FLAP YOU DIDN'T CHANGE THE SHAPE OF, not only will it not lie back down correctly, it will MASK the effect of the new (correct) surface a bit, and also may NOT CONFORM properly, causing wrinkles or striae which can DISTORT vision and cause DIPLOPIA OR DOUBLE VISION. This is TOTALLY AVOIDED WITH LASEK as there is NO FLAP TO MASK OR DISTORT THE NEW CORRECT SURFACE YOU GET after the laser. So I can treat up to 4, 5, or even 6 diopters of cylinder (astigmatism) with LASEK--or almost TWICE as I could reliably and safely treat with LASIK without striae.
