What to Know About Astigmatic Keratotomy

An ideal cornea should be round for light to properly focus on the retina. But, with astigmatism, the cornea is more curved in one direction than another.

This irregular shape can lead to vision problems such as blurred vision, eye strain, and night vision issues. Fortunately, astigmatic keratotomy (AK) is a simple and effective procedure that can correct astigmatism and improve your vision.

Let’s discuss more about it so you can make informed decisions for your vision health.

What is Astigmatic Keratotomy?

Astigmatic keratotomy, or arcuate keratotomy (AK), is a procedure that corrects astigmatism. It’s a type of corneal relaxing incision (CRI) surgery that flattens the steeper areas of your cornea.

AK is usually performed with a laser, resulting in more precise outcomes. The duration involves making one or two small incisions at the steepest part of the cornea, causing them to relax and take a more rounded shape.

AK tends to be more effective for older people and people with mild glasses or contact lens prescriptions. Additionally, people with severe astigmatism may still require glasses or contacts after the procedure.

What Can You Expect From Astigmatic Keratotomy?

Before the surgery, your surgeon will map your eye with corneal topography. This helps guide them on where to make the incisions.

They’ll also need to perform corneal pachymetry, which measures the thickness of the corneal tissue. This helps them determine how deep the incisions can go.

What Happens During the Procedure?

During the procedure, the surgeon will apply anesthetic eye drops before placing a lid speculum to hold your eye open. They’ll then place temporary markings on the cornea to indicate where to make the incisions with a laser. 

They typically make one or two incisions parallel to the edge of your cornea along the steepest part of your cornea. Generally, the deeper or longer the incision, the more astigmatism is corrected.

What Happens After Surgery?

The procedure typically takes about 5 to 10 minutes per eye, and you can go home shortly after surgery. The surgeon will prescribe antibiotic eye drops and possibly steroid eye drops to manage pain and prevent infection. 

You may need to use eye shields to protect your eyes after the procedure. If you experience discomfort, you can take certain over-the-counter (OTC) pain relievers.

Other post-surgical side effects include:

• Tearing
• Mild swelling
• Light sensitivity
• Redness
• Scratchy eyes

These symptoms are normal and usually go away within a day or two. Full healing time is about 2 to 3 months, although your vision should improve within a day or so. Most people can return to work and resume normal activities the next day.

Astigmatic Keratotomy Surgery Complications

AK is considered safe, but there is a small percentage of experiencing complications, such as:

• Overcorrection or undercorrection
• Light sensitivity 
• Prolonged or permanent glare and halos
• Weaker corneal structure
• Infection

If you’re experiencing any of these symptoms, talk to a doctor immediately.

Who’s A Good Candidate for Astigmatic Keratotomy?

Oftentimes, AK is performed on people who have residual astigmatism from previous eye surgeries, such as cataract surgery, radial keratotomy, and corneal transplant.

However, you’ll have to meet the following criteria to receive AK surgery:

• Mild to moderate astigmatism
• Stable eyeglass prescription for at least 1 year
• Good overall health
• No autoimmune diseases like diabetes 
• No eye problems that may affect recovery, such as severe dry eyes

Astigmatic keratotomy is a safe and effective way to correct astigmatism and improve your vision. If you're a good candidate for the procedure, it may be the perfect solution for you. We encourage talking to your eye doctor to see if AK is right for you.