Astigmatic Keratotomy

This is a surgical procedure which is used to treat astigmatism. It is similar to Radial Keratotomy (RK) in that the surgeon makes a couple of incisions in the cornea to change it from an oval (rugby ball) shape to a rounded (football) shape.

This procedure can be carried out as a standalone technique or in combination with laser vision treatments such as PRK or LASIK. It is ideal for patients with mild to moderate astigmatism.

Patients with severe astigmatism may find that they still have to wear glasses or contact lenses after surgery although at a lower prescription.

1. What is ‘AK?’
2. How does it differ from laser eye procedures such as LASIK?
3. Who should consider AK?
4. What are the risks of AK?
5. What are the benefits of AK?
6. What should I ask the surgeon at the consultation?
7. How much does AK cost?
8. What is the AK procedure?
9. How long do the effects of AK last for?
10. What does recovery from AK involve?

What is ‘AK?’

AK or ‘Astigmatic Keratotomy’ is a form of eye surgery which can correct astigmatism. It is carried out under a local anaesthetic (eye drops) and involves changing the steepest part of the cornes so that it assumes a more rounded shape.

How does it differ from laser eye surgical procedures such as LASIK?

If differs in that a precision knife blade, rather than a laser is used to correct astigmatism. This is still a painless form of treatment and one that is both safe and effective.

However, many people are choosing to have LASIK or other forms of laser vision correction instead as these are seen as both quicker and more efficient.

With AK, it can take up to 3 months before your eyes are fully healed.

Who should consider AK?

If you have mild or moderate astigmatism, are in good health and have an open mind about this surgery then you will be considered for AK.

The surgeon will take a variety of factors into account, such as age, lifestyle, the condition of your eyes and reasons for surgery. He or she will also ask you about your medical history. This is important as he/she is not only checking on your general health but wants to know if you have or have suffered from any eye diseases, e.g. glaucoma.

What are the risks of AK?

There are risks with all forms of eye surgery. Surgery is, in general, very safe and complications are rare. However, things can go wrong in a small minority of cases.

There are side effects and complications associated with AK which are:

• Sensitivity to light
• Glare
• Starbursts
• Halos
• Infection
• Fluctuations in eyesight
• Cornea is weakened which means an increased risk of trauma/disease
• Problem with wearing contact lenses

What are the benefits of AK?

The main benefit of this surgery is improved astigmatism.

What should I ask the surgeon at the consultation?

Our section entitled ‘Laser Eye Surgery: General FAQS’ contains useful information on what to ask your eye surgeon. These include checking his/her qualifications and level of experience, the surgery itself and how long does the recovery take.

You want to be satisfied that he/she is the best person for the job. Finding a good, reputable surgeon is of vital importance and one in which you need to spend some time doing so.

If the surgeon appears to be evasive, pushy or uninterested then go somewhere else.

How much does AK cost?

Costs of procedures vary between clinics. Contact a range of clinics to see what their prices are and how they compare.

There is always the option to go abroad for eye surgery as prices are very often lower than the UK. However, there are risks with this so consider this option very carefully.

What is the AK procedure?

You will have been given a set of instructions beforehand on how to prepare for this surgery. These will include eating a light meal on the day of surgery and arranging for someone to drive you home afterwards.

You will be offered a sedative just before the start of the treatment

The surgeon will put anaesthetic drops into your eyes to numb the areas to be treated.

He or she will use a diamond knife blade or single use blade to make two incisions in the deepest part of the cornea.

This will relax the oval shape of the cornea into a more normal rounded appearance.

This procedure can be performed on its own or in conjunction with other forms of eye surgery such as LASIK.

How long do the effects of AK last for?

As far as we know the effects are permanent. But, the eyes are subject to change over time so further surgery may be needed.

This procedure cannot guarantee unaided vision: by that we mean, vision without glasses or contact lenses. It can reduce astigmatism but cannot eliminate it completely.

Further surgery in the shape of LASIK is required to achieve perfect eyesight.

What often happens is that the surgeon will carry out AK and then wait for 3 months or so before performing LASIK.

What does recovery from AK involve?

Your eye will be covered with a light bandage and you will be given antibiotic eye drops to reduce the risk of infection. You will be able to remove this bandage after a few hours.

It is a good idea to ask someone to drive you home after surgery as you will be unable to do so.

Once home, use the eye drops which will take care of any discomfort that you may experience. This discomfort can be ‘scratchy’ eyes or feeling as if their eyes have something in there, such as a foreign body which they cannot shift. These will ease after a short period of time.

You will be able to go back to work 3 to 5 days following this surgery. This also means that you can resume your normal activities and sport/exercise.

The results of this surgery can be seen the day following your surgery although it will be a few weeks before your eyes fully settle down.

If you had severe astigmatism then you will find that the surgery has not completely resolved this and that you will still need to wear glasses. However your prescription will have changed in that it will show a lower level of astigmatism (mild refractive error).