Is it Worth it to Have Astigmatic Keratotomy (AK)?
When you’re considering any elective medical procedure, you need to know the risks, and weigh them against the benefits. The choice of whether or not to have an elective procedure is very personal, and every person will make their choice differently. Here, we’ll discuss the major risks and benefits of having astigmatic keratotomy (AK).
Astigmatic keratotomy is a procedure in which incisions are made in the surface of the cornea. The procedure is used in astigmatism, which is a condition in which the cornea is curved more in one direction than in the other; the incisions are intended to bring the curvature of the cornea more into balance. The type of incisions used are almost always limbal relaxing incisions (LRI), which are made near the edge (limbus) of the cornea; the term LRI is sometimes used as a synonym for AK, although AK can also include corneal relaxing incisions (CRI), which are made closer to the center of the cornea. For more on what it’s like to have AK, please see Astigmatic Keratotomy (AK): the Procedure and Recovery.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the provider who will perform your procedure if you decide to proceed.
Any treatment has risks, and it’s important to be aware of them so that you can weigh them against the benefits.
Astigmatic keratotomy can lead to problems with the eye. There is a chance of bleeding or fluid collecting within the eye, which raises the eye pressure and may also potentially lead to blindness. The rise in eye pressure may require surgery, long-term medications, or both, and may damage the eye irreversibly. Because the eye is being cut, there is a risk of infection, which may require antibiotics and could also cause permanent damage to the eye.
The procedure could also cause damage to the cornea. Scars could form, and these could potentially interfere with vision. Sometimes, corneal surgery leads to a weakening of the structure of the cornea. This can lead to keratoconus or keratectasia, problems in which the cornea is excessively curved. This may cause the patient to continue to need corrective lenses, and in some cases a corneal transplant may be needed for the person to be able to see again.
Additionally, the procedure may not produce a beneficial effect on your vision. It may fail to correct your astigmatism, or may even create a different type of astigmatism. Even if it does give you better visual acuity, there may be other effects on your vision. There may be starbursts or halos around lights, or “ghosting” of images (double vision). These visual effects may interfere with driving at night or other activities.
Astigmatic keratotomy is an irreversible procedure. It’s important to consider this carefully before deciding to have the procedure performed on your eye(s).
While refractive surgery such as AK does have risks, its benefits are also significant, and the majority of people who receive this surgery are satisfied with the outcome. AK can offer some people who must wear glasses or contacts for astigmatism freedom from the hassle of these devices. With glasses, people may be restricted from participating in certain types of activities, particularly sports; AK may allow them to do the things they love. Additionally, many find wearing glasses uncomfortable on the bridge of the nose or tops of the ears, and many also don’t like the look of glasses. Contacts are uncomfortable and easy to lose, and some people are unable to tolerate contacts due to certain features of their eyes, and for those with very strong prescriptions, contacts may not even be possible.
For those who are having LASIK or a similar procedure to correct myopia (nearsightedness) or hyperopia (farsightedness), there may be too much astigmatism for the laser corneal surgery alone to correct. The use of AK along with the laser procedure may allow these people to become free of glasses or contacts, when they otherwise would have continued to need lenses after the procedure.
The cost for astigmatic keratotomy is around $500 to $600 per eye. This cost varies depending on several factors, including the region and the particular surgeon. You should check with the provider(s) you’re considering to determine the exact cost. Keep in mind that financing is often available. For more detail, visit our Astigmatic Keratotomy (AK) Cost page.