Can LASIK Correct Astigmatism and Presbyopia? What’s New in 2025

LASIK has long been the go-to for nearsightedness and farsightedness, but what about astigmatism and presbyopia, the 2 most misunderstood vision issues that hit in very different ways? LASIK can address both. In 2025, LASIK is doing it with more precision than ever before.

Astigmatism isn’t a disease; it just means your cornea (or sometimes your lens) isn’t perfectly round. Instead of focusing light evenly, the eye bends it more in one direction than the other. The result? Blurry, distorted or “shadowy” vision at all distances.

Today’s LASIK doesn’t just flatten the cornea; it reshapes it in a customized pattern, guided by detailed corneal mapping. Topography-guided LASIK, also known as Contoura Vision, allows surgeons to smooth microscopic irregularities and treat astigmatism with sub-millimeter precision.

What does that mean for patients? Sharper vision. Fewer visual distortions. And in many cases, better-than-20/20 results.

Presbyopia can begin around your 40s or 50s, when reading menus suddenly becomes a two-hand operation. This age-related change isn’t about your cornea—it’s your lens losing flexibility. Most people solve it with reading glasses, but let’s be honest: few love that solution.

Can LASIK correct presbyopia? Technically, not in the traditional sense, but modified LASIK techniques can offer freedom from readers for many patients.

Here’s what’s new in 2025:

• Monovision LASIK: 1 eye is corrected for distance, the other for near. It’s not for everyone, but when it works, it works well. A contact lens trial is usually done first to simulate the experience.
• PresbyLASIK (multifocal ablation): This newer method reshapes the cornea to create multiple focal zones, somewhat like a multifocal lens—but on the eye itself.
• Adjunct options: For some, LASIK paired with a corneal inlay or light-adjustable lens (LAL) post-cataract surgery may provide even better range of vision without glasses.

Your eye doctor will assess not just your prescription, but your lifestyle, age, occupation and visual goals to determine if LASIK, or another refractive procedure, is the right fit.

This year, we’re seeing AI-enhanced surgical planning take the guesswork out of LASIK outcomes. Algorithms now analyze corneal data, pupil size, tear film quality and even night vision risks to guide treatment settings.

Also on the rise: adaptive optics simulations that let patients “preview” their post-LASIK vision in real time, helping them make more informed decisions about monovision or astigmatism correction. 

If you’ve been told in the past that LASIK wasn’t right for your astigmatism or your over-40 eyes, it might be time to revisit the conversation. The tools have changed. The techniques have advanced. And your vision goals deserve a second look.

To find out if you’re a candidate for custom LASIK or other advanced options, contact Great Plains Eye Specialists at 605-718-5123 or WEBSITE to schedule a consultation.