Vision Blurred (Astigmatism) Surgery

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KEY POINTS

• Astigmatism surgery is a procedure in which a provider makes cuts in the cornea to reduce blurred vision caused by an uneven curve in your cornea.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is astigmatism surgery?

Astigmatism surgery is a procedure in which a provider makes cuts in the cornea to reduce astigmatism. Astigmatism is blurred vision caused by an uneven curve in your cornea. The cornea is the clear outer layer on the front of the eye. As a result of astigmatism, your vision is somewhat blurry close up and far away.

The surgery is also called astigmatic keratotomy (AK).

When is it used?

AK can be used to improve blurry vision caused by mild to moderately severe astigmatism. You may not need glasses or contact lenses any longer or you may be able to have thinner lenses in your glasses. To determine whether you can benefit from AK, see your eye care provider. After examining your eyes, your provider will tell you if AK might be helpful for you.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Do not wear rigid contact lenses for 3 weeks before the surgery or soft contact lenses for 2 weeks before your appointment for evaluation for surgery. Contact lenses can change the shape of the cornea and prevent accurate measurements.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.
• Follow any instructions your healthcare provider may give you.
• Plan for your care and a ride home after the procedure.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Do not wear eye makeup on the day of the surgery.

What happens during the procedure?

You may be given a sedative to help you relax. Then your eye provider will put special eye drops in your eye to numb it. While you are lying under the microscope, your provider will make tiny cuts in your cornea. No cuts are made in the center, which is the part you see through. The length, depth, and placement of these cuts depend on how much your cornea needs to be reshaped. The cuts allow the cornea to flatten and become more evenly rounded.

AK usually takes less than 20 minutes. You will feel little or no discomfort during the procedure. Usually your provider will treat one eye at a time. Some people need more than one AK treatment to correct their vision.

What happens after the procedure?

You will be in the recovery area for about an hour after surgery or until you are ready to go home. You may want to relax at home for the rest of the day.

You will be able to resume most of your normal activities soon after the procedure. Wear your old glasses or safety glasses to protect your eye from injury. Do not rub your eye.

You may feel some discomfort. Your eye will probably feel gritty for a few days. It may look red and be more sensitive to light than usual. You may see halos around lights.

Your provider will give you eye drops and may prescribe pain medicine. The drops will help the cornea heal and will help prevent eye infections.

Usually the cornea heals slowly. Your vision may continue to change for weeks or months after the procedure. Some people still need to wear glasses or contact lenses. After age 40 you may need reading glasses for close work.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid
• How to take care of yourself at home
• What kind of symptoms or problems you should watch for and what to do if you have them.
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Return of your astigmatism after a while
• Scarring of your cornea
• Cataract, which is a cloudy area in the lens of the eye
• Eyelid problems
• Dry eye
• Eye infections
• Loss of vision (rare)

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.