LaserSurgeryForEyes.com

Glasses and contact lenses are only temporary solutions. When you take them off, your vision blurs again. There are also various other factors, like allergies, that prevent many people from wearing contact lenses. And of course, there are times when surgery and only surgery can restore vision.

Astigmatic Keratotomy is a variation of the Radial Keratotomy procedure. The purpose of AK is to remove or reduce astigmatism. This is achieved through a series of small incisions in a curved pattern.

As opposed to RK, AK is still practiced on a fairly regular basis in conjunction with other surgeries. Often times when a patient goes in to have LASIK performed, the surgeon will use the laser to correct myopia or hyperopia, then use the Astigmatic Keratotomy procedure to correct the patients astigmatism. Recently though AK has begun to be phased out in favor of Limbal Relaxing Incisions(LRI).

Do you qualify for AK?

You must be at least eighteen years of age to have the AK procedure performed. Prior to the surgery, your eye physician will perform a complete physical on your eye. This will be done to determine the necessary amount of correction, and whether or not you are a good candidate for surgery. In addition, your physician will need your full eye history for the past year, as he will need to know that your prescription has remained stable for at least that amount of time. Preparations for the surgery are dependent on whether or not you wear contacts, as contacts can lead to imprecise measurements and poor results. If you wear hard or gas permeable contact lenses, you will need to refrain from wearing them for two to three weeks. If you wear soft lenses, you will need to refrain from wearing them for one week.

|Top|

The Procedure

The patient is given a mild sedative prior to surgery and the eye is prepped normally. Generally, the non-dominant eye is selected for the first go-around, with an average minimum wait of one week before surgery is performed on the dominant eye. Under no circumstances are both eyes operated upon on the same day!

During the operation, the front surface of the eye is numbed with drops. Some surgeons advocate retro-bulbar anesthesia. However, its use is not necessarily warranted and some of these cases have developed acute optic atrophy, resulting in total vision loss. A mark in a spoke-like pattern is then impressed upon your cornea. This is temporary and is used for marking where the surgeon will make the incisions. The marks are based upon a formula determining your prescription, age, and the amount of correction needed. The surgeon will then make several incisions (keratotomies) in the cornea using a microscope and a microscopic surgical instrument that has a diamond tip. This diamond instrument has a safeguard which prevents it from penetrating into your eye. The actual surgery time takes about 5 minutes but with pre-operative preparations it can take up to an hour.

Precise microscopic control must be maintained over the length, depth, and arrangement of these micro-incisions in order to achieve proper optical correction. These micro-incisions allow the central cornea to round out, removing the aspherical shape tha causes astigmatism, thus partially or completely correcting the vision impairment.

Antibiotic and cycloplegic drops are then applied and the lid speculum removed. A patch is then placed on the eye for approximately 2 hours. Other than diligent care to avoid getting the eye patch soiled or wet, there are no restrictions placed on the patient. Antibiotic drops are used for l-2 weeks after the surgical procedure.

|Top|

After

For the first 24 hours after the surgery, you may experience some sensitivity to light, mild scratchiness, and/or redness in the operated eye. There may also be some pain which is usually alleviated by common, over-the-counter medication.

Vision is usually good within the first week, but fluctuation of visual acuity from morning to night can be expected for up to 6 months or longer. Occasionally, a second operation is needed to reduce any residual myopia.

Glare at night can also be expected for the same length of time. Some patients have complained for up to 3 years. However, glare testing shows no significant glare after 1 year in 99.3% of the cases. Approximately 83% of patients in the expected range achieve unaided post-op 20/40 (or better) vision. Regression of effect over time has not been observed with the newer techniques. Check our news link for recent developements.

return to home