Astigmatic keratotomy eye surgery is safe and effective, but in recent years has been largely replaced by LASIK, according to doctors from The Cleveland Clinic. The cornea of people who have astigmatism is shaped like a football. Astigmatic keratotomy eye surgery corrects astigmatism by making one or two incisions at the steepest part of the cornea. These incisions cause the cornea to relax and take a more rounded shape.

People with mild prescriptions generally have the best success in obtaining normal vision after astigmatic keratotomy eye surgery. People with more severe astigmatisms may still require glasses or contact lenses after astigmatic keratotomy eye surgery.

What Are the Advantages of Astigmatic Keratotomy Eye Surgery?

Astigmatic keratotomy eye surgery is a safe and effective way to correct astigmatism.

What Are the Disadvantages of Astigmatic Keratotomy Eye Surgery?

  • Slow healing process (about three months)
  • Discomfort (usually lasting 2-3 days)
  • Results, both good and bad, are irreversible

What Are the Potential Side Effects of Astigmatic Keratotomy Eye Surgery?

Although rare, side effects from astigmatic keratotomy eye surgery can occur. They may include:

  • Fluctuating vision, especially during the first few months after surgery
  • A weakened cornea, more vulnerable to rupture if hit directly
  • Infection
  • Difficulty in fitting contact lenses
  • Glare or starburst around lights that can sometimes be permanent

How Should I Prepare for the Procedure?

Before your astigmatic keratotomy eye surgery you will have met with a coordinator who will discuss what you should expect during and after the surgery. During this session your medical history will be evaluated, and your eyes will be tested. Likely tests include measuring corneal thickness, refraction, and pupil dilation. Once you have gone through your evaluation, you will meet the surgeon, who will answer any further questions you may have. Afterwards, you can schedule an appointment for astigmatic keratotomy eye surgery.

If you wear rigid gas permeable contact lenses, you should not wear them during the three weeks before astigmatic keratotomy eye surgery. Other types of contact lenses shouldn't be worn for at least three days prior to astigmatic keratotomy eye surgery. Be sure to bring your eyeglasses to the surgeon so your prescription can be reviewed.

On the day of your astigmatic keratotomy eye surgery, eat a light meal before going to the doctor's office, and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you do not feel well that morning, call the doctor's office to determine whether the astigmatic keratotomy eye surgery needs to be postponed.

What Happens During Astigmatic Keratotomy Eye Surgery?

Astigmatic keratotomy eye surgery is done under a local anesthesia and the entire procedure lasts a maximum of 10 minutes for both eyes. It involves making one or two incisions at the steepest part of the cornea. This causes the cornea's football-shape, which is causing the astigmatism, to relax into a rounded shape.

What Should I Expect After Astigmatic Keratotomy Eye Surgery?

Your eye may be sensitive to light for a few hours or feel like there is a foreign object in it. Your doctor will prescribe eye drops for you that will help prevent infection and inflammation, and reduce the feeling that you have a foreign object in your eye.

While a reduction in the astigmatism is often observable by the day after surgery, it generally takes a few weeks before the results stabilize. In cases of severe astigmatism - which can be reduced by astigmatic keratotomy eye surgery but not eliminated -- new eyeglasses will be prescribed a month after surgery.

Very often people with astigmatism also have another vision problem, such as farsightedness . For these people, their vision without eyeglasses after the astigmatic keratotomy eye surgery may get worse at first. In order to achieve good vision without eyeglasses, a second procedure, such as LASIK must be performed at a later date.

Reviewed by the doctors at The Cleveland Clinic Cole Eye Institute.

Edited by Charlotte E. Grayson, MD, WebMD, October 2004.

Portions of this page © The Cleveland Clinic 2000-2005


The colored part of the eye that helps regulate the amount of light that enters is called the: See Answer

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