This is a refractive surgical procedure that is used to correct astigmatism. When the surface of the cornea is more curved in one direction than in another, then the light that enters the cornea refracts not into one but into several points inside the eye. This causes blurred and distorted vision.
For the treatment of astigmatism, incisions into the steepest parts of the cornea are strategically placed, leading to its maximum flattening. This enables light to fall more precisely onto the retina leading to sharper and clearer vision.
AK takes only a few minutes and may be used together with other refractive methods or by itself.
Many different forms exist. These are the most common ones:
Arcuate keratotomy
Arcuate (arched) keratotomy is a surgical procedure whereby arc-shaped incisions are made into the steepest axis of the cornea (in the optical zone 7–9 mm) using a diamond knife (approx. into 95% depth). The effect of arcuate keratotomy is increased by lengthening the incision and bringing it closer to the centre (incisions in the optical zone 7 mm are more effective than in the 9 mm zone).
The condition post limbal relaxing incision using Femtolaser
The setting of the diamond knife for performing manual corneal incision
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Limbal Relaxing Incision (LRI)
LRI are incisions set at a depth of approximately 600 µm, placed directly in front the limbus (where cornea and sclera meet). Increased effectiveness of LRI is achieved mostly through lengthening of the incision or doubling it. This type of procedure is also performed using the special diamond knife.
Femtosecond Laser Arcuate Keratotomy (FLAK)
Femtosecond Laser assisted arcuate keratotomy is an alternative to the procedure carried out using a diamond knife. It uses Femtosecond Laser to precisely make arc-shaped incisions in the central periphery of the cornea. FLAK may be performed in combination with Refractive Lens Exchange, cataract surgery or as a procedure by itself. It may be used as a solution in cases where greater degrees of astigmatism are diagnosed (this may occur following surgical transplantation of the cornea).
The FLAK procedure is painless, exact and fast. It is usually completed within a few minutes of which the laser works only a few seconds.