Astigmatic Keratotomy

Before the day of your surgery, our refractive eye surgeon will do a thorough evaluation to plan your astigmatic keratotomy. This involves several detailed measurements aimed at understanding the specific curvature and thickness of your cornea.

Preoperative tests typically include:

• Manifest Refraction: To determine your current level of astigmatism.
• Keratometry: This measurement confirms the number of diopters (the unit for refractive error) in your corneal astigmatism.
• Corneal Topography: A detailed map of your cornea that shows the steep and flat axes, which is crucial for planning the exact location and length of the incisions.
• Pachymetry: A measurement of your corneal thickness, help ensuring the incisions are made at a safe depth.

Based on these measurements, our refractive eye surgeon determine whether manual or laser-assisted techniques are most appropriate for your situation and how many incisions are necessary. The goal is always to leave you with as little residual astigmatism as possible.

• Manual Incisions: With your eye in a steady position, the doctor marks the cornea using specialized instruments. A diamond blade is then carefully applied to create the precisely measured incisions. As the blade is drawn across the cornea, it gently “relaxes” the steepest areas to help reduce astigmatism.
• Laser-Assisted Incisions: If you’re having a laser-assisted procedure, a femtosecond laser is used to create the incisions. Using preoperative imaging and nomograms for guidance, the laser makes arc-like cuts with remarkable precision. These incisions may be made during the cataract surgery or at a separate, but coordinated, time point depending on your specific needs.

During the procedure, advanced tools – such as intraoperative measurements – may be used to verify that the incisions are accurately placed. This step is vital as it accounts for any minor rotational changes in your eye, ensuring that the correction is both effective and safe. The entire process is designed to be efficient and minimally invasive, with results that many patients notice almost immediately in the clarity of their vision.

• Medicated Eye Drops: A combination of steroid and antibiotic drops is usually prescribed to reduce inflammation and prevent infection.
• Short Recovery Period: Since the incisions are small and made with precision, many patients experience minimal discomfort and can return to their daily routines quickly.
• Follow-Up Appointments: Our refractive eye surgeon will schedule postoperative visits to monitor your healing, check for any residual astigmatism, and make any necessary adjustments.

While many patients experience noticeable improvement in their vision shortly after the surgery, complete stabilization of the corneal shape can take a few weeks. It’s important to follow the postoperative care guidelines carefully to ensure the best possible healing process. If you experience discomfort, unusual redness, or any changes in vision during your recovery, please reach out to our office for advice and support.

Benefits of Astigmatic Keratotomy

Astigmatic keratotomy offers a range of benefits designed to improve the quality of your vision. Some of the most notable benefits include:

• Enhanced Visual Clarity: By correcting even subtle irregularities in the corneal curvature, AK can dramatically improve the sharpness and clarity of your vision.
• Reduced Dependence on Corrective Eyewear: Many patients report a decreased need for glasses or contact lenses after undergoing astigmatic keratotomy.
• Tailored Treatment: The procedure is customized to your individual eye measurements and needs, ensuring that the correction is precisely what you require.
• Integration with Cataract Surgery: For those undergoing cataract surgery, treating astigmatism at the same time offers the benefit of a single, streamlined procedure with optimized outcomes.

Potential Risks of Astigmatic Keratotomy

However, patients should be aware of potential risks, which include:

• Overcorrection or Undercorrection: In some cases, the amount of astigmatism corrected may be more or less than intended. If this occurs, further adjustments or additional procedures may be necessary once the eye has stabilized.
• Discomfort: While most patients report minimal discomfort, some may experience temporary irritation or sensitivity as the incisions heal.
• Risk of Infection: Although rare, any incision in the eye carries a small risk of infection. This is why a strict postoperative regimen with antibiotic drops is important.
• Potential for Irregular Astigmatism: In very rare cases, the incisions may induce a different pattern of astigmatism. Careful surgical planning and technique help minimize this risk.

It’s vital to discuss any concerns with our refractive eye surgeon. They will evaluate your overall eye health, the degree of astigmatism you have, and other individual factors to help decide whether astigmatic keratotomy is the most suitable option for you.