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Astigmatic Keratotomy

Astigmatic Keratotomy (AK) is used to reduce severe astigmatism of approximately 5 dpt or higher.

Normally, the surface of the cornea is curved evenly like the surface of a ball. In the case of astigmatism, the curvature is stronger in one direction than in the other, so that images appear distorted.

A mild astigmatism can be corrected with eyeglasses, contact lenses or eye laser procedures such as LASIK. However, more severe astigmatism cannot that easily be corrected.

Astigmatic keratotomy is indicated for the reduction for severe astigmatism, although in most cases it cannot be corrected entirely. In a typical scenario, an astigmatism is first reduced with the Astigmatic Keratotomy and a couple of months later eliminated altogether with a LASIK procedure.


What happens during the Astigmatic Keratotomy procedure?

For the procedure, an arch-shaped deep incision is placed in the axis of the strongest curvature on the periphery of the cornea. At FreeVis, we use the femtosecond laser to precisely and accurately cut the corneal tissue. This incision relaxes the corneal tissue in the axis and results in a reduction of the curvature and thereby in a reduction of the astigmatism.


Typical course of an Astigmatic Keratotomy procedure and recovery after the surgery

The astigmatic keratotomy is an outpatient procedure. Prior to surgery, you will be offered a relaxant. The eye is then anesthetized locally with eye drops so that you will not feel any discomfort during surgery. For the surgery, which only lasts a few minutes, your eye is fixated with light pressure by a special ring-shaped device. The procedure is painless.

After the surgery, the eye is covered with a clear bandage, which you may remove a few hours later. It is possible that a small foreign body sensation or slight discomfort may occur for a few hours following the procedure.

A reduction of the astigmatism can be observed as early as the day after surgery. However, it takes a few weeks until the result is stabilized. Usually, new eyeglasses have to be prescribed a few days after the surgery because the astigmatism has been reduced but not eliminated altogether. You will receive eye drops, which have to be applied for several days after surgery, and you will generally be able to resume work within a few days after the procedure.

Treatment costs

In Germany, the treatment costs for astigmatic keratotomy are not covered by public or private health insurances. This fact also applies in cases of documented intolerance to eyeglasses or contact lenses. Currently, the costs for the preoperative and postoperative exams are also to be paid by the patient and are calculated in accordance with the German coding system for the calculation of medical services (Gebührenordnung für Ärzte – GOÄ).
Please feel free to inquire about the costs for this procedure.


What problems can occur?

After an astigmatic keratotomy, your vision without eyeglasses may initially get worse, especially in cases of a combination of farsightedness and astigmatism.

The vision you can achieve with eyeglasses will be better after the operation than before, because the astigmatism has been reduced. It is likely that a new prescription for eyeglasses will be required before operating a motor vehicle.

Good vision without eyeglasses will be achieved after a second procedure such as LASIK is performed.

Although severe side effects are not likely, they cannot be excluded completely. In some cases, an irregular astigmatism may occur. In extremely rare cases, a perforation of the eye may occur because the incision was placed too deep.