Astigmatic Keratotomy - Laser Eye Surgery Guide

Astigmatic keratotomy (AK) is a surgical procedure that is employed to treat and resolve astigmatism. The surgery is performed under a local anaesthetic and is not dissimilar from radial keratotomy (RK) in that they both involve the surgeon creating small incisions in the cornea. These incisions are made to convert the shape of the cornea from oval to spherical.

AK can be performed as an individual procedure or it can be combined with various laser eye surgeries, such as LASEK, to further improve vision.

It is deemed as an ideal procedure for those individuals who suffer from mild to moderate astigmatism and wish for it to be corrected. If your astigmatism is classed as severe, then it may be necessary for you to continue sing visual aids such as glasses or contact lenses after your AK surgery, however they will be a lower prescription.

In what ways is AK difference from other laser eye surgeries?

Similarly to laser eye surgeries such as LASIK, LASEK and PRK, AK is a very safe and effective procedure. However, rather than being performed using a laser for correction, AK employs the use of a knife blade to resolve the astigmatism.

Although AK is a safe method of eye surgery, many people are showing preference to the more innovative laser techniques of vision correction. This is generally because such methods are classed as more efficient and less time consuming in terms of both the procedure and recovery – it can take your eyes up to 3 months to fully recover from AK surgery.

Am I a suitable candidate for AK?

There are a number of general guidelines that should be abided by in order to class you as a suitable candidate for AK. These guidelines include you being in good, overall health, having mild to moderate astigmatism and being realistic about the outcomes of your AK surgery.

During your consultation your surgeon will contemplate various other factors including:

  • Age
  • Lifestyle
  • Eye health – past and present
  • Your personal justification for undergoing AK
  • Medical history

Potential risks of the AK procedure

Generally speaking, AK is a very safe procedure, but there are some rare risks that may affect you and are therefore worth considering. Such risks and side effects specifically related to AK include:

  • You may experience light sensitivity
  • Glare, starbursts or halos
  • An eye infection may develop
  • The quality of you eyesight may fluctuate and vary
  • You may be at higher risk of suffering diseases or trauma as the cornea is less robust
  • You may be unable to wear contact lenses

Benefits associated with AK

It is simple enough to list the benefits of AK, as there is just one key one. This benefit is the significant improvement of your astigmatism. This is a point that many patients feel overrules all the potential risks, however this is entirely personal to you.

Your AK consultation

You must attend a consultation prior to undergoing the AK surgery. Your surgeon conducts this meeting and the time is used to assess your suitability for the procedure. You should use your consultation time to get to know and build up trust with your surgeon. This can be done through a number of questions that you should try and think of before the appointment. For advice of the type of questions you may wish to consider, please visit our page entitled 'Laser Eye Surgery: General FAQs'.

The types of questions you may wish to ask could include about the surgeon's qualifications, skills and experience as well as the actual surgery and recovery period. Only commit yourself to that surgeon if you are satisfied with the answers to all of your questions. Do not feel that just because you have had a consultation with them that they must be the surgeon to carry out the AK.

At the end of your consultation, if you are considered a suitable candidate for AK, your surgeon should be able to provide you with a quote as to how much your surgery will cost. This price will vary from clinic to clinic so it may be worth collecting a small database of quotes and comparing them in terms of quality and suitability for you.

The AK procedure

During your consultation you will be supplied with an outline of how best to prepare yourself for the AK procedure. Such instructions will probably include only eating a small meal on the day of the AK as well as ensuring you have a friend or family member prepared to transport you home from the clinic.

Before the surgery begins your surgeon may offer you a sedative to ensure you are as relaxed as possible. Your eye will then be held open by a special clip and numbing eye drops will be applied. This will minimise the amount of pain and discomfort you may feel during the procedure.

Once the area has been numbed, the surgeon with use a blade to create two cuts in the cornea. These cuts are done so the cornea's shape will relax from an oval into a flatter, more spherical appearance.

The AK surgery may be performed on its' own or if you wish to improve your vision further, it may be done in conjunction with a laser technique such as LASIK.

How long can I expect the result of AK to last?

To the best of our knowledge, the outcomes of AK are permanent however it is natural for your eyesight to change as we age. This may lead to you desiring further surgery in future.

AK is not able to 100% guarantee that you will have perfect vision; it is entirely possible that you will still require the use of visual aids such as glasses or contact lenses. Despite this, the surgery will significantly reduce astigmatism, which can be life changing in itself. However, if you do desire perfect vision then you may wish to combine the AK surgery with a procedure such as LASEK, LASIK or PRK.

The AK recovery period

To aid the healing process after you have undergone AK, a bandage or eye patch will protect your eye for a few hours. You will also be administered special antibiotic eye drops to use regularly to minimise the chances of an infection occurring. The eye drops will also be useful for dealing with any pain or discomfort that you may suffer once you get home.

Some people get the feeling of something being in their eye, which can be very irritating and uncomfortable. This can also be eased with the use of eye drops and should subside quickly.

You should be able to notice the results of your surgery the following day, however you should still take a few days off work to relax and give your eye the healing time that it needs. After these days, you should be able to return to you everyday activities, including sport. You should consult your surgeon for further advice on this. In total, however, it will take a few weeks for the complete benefits to reveal themselves.

If you underwent AK to fix severe astigmatism then it is probable that you will still require glasses or contact lenses. Despite this, your prescription will probably be lighter as your astigmatism will have eased to a more mild form.