No, you can be wide awake during cataract surgery, but you will need some type of local anesthesia (eye drops or injection). I was awake and could feel pressure during the surgery but no pain. Astigmatism can be corrected at the time of surgery with limbal relaxing incisions or a toric IOL. The "best" method depends on the surgeon's experience and skills and the amount/type of astigmatism. After surgery, LASIK or PRK can correct astigmatism.