What is Keratotomy?
Keratotomy is defined as any surgical cut into the cornea. The cornea is the clear tissue which covers the front part of the eye. Keratotomy is a surgical procedure performed by an eye surgeon known as an ophthalmologist. It is commonly done to neutralize the eye’s prescription and get rid of the need to wear eyeglasses, similar to LASIK refractive surgery.
Radial keratotomy is refractive surgery that cuts into the cornea to change the eyeglasses prescription. A Radial keratotomy is done to eliminate nearsightedness or myopia. Radial Keratotomy was used in the 1970s, before the invention of LASIK refractive surgery in 1998. Nowadays, radial keratotomy is considered an outdated surgery due to more precise technology such as LASIK refractive surgery. However, keratotomy techniques are still used to treat astigmatism during cataract surgery.
Key Takeaways
- Keratotomy is any surgical procedure that involves cutting the cornea.
- Keratotomy is typically performed to change the prescription of the eye.
- Radial keratotomy was mostly used in the 1970s prior to the invention of LASIK refractive surgery.
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Understanding Keratotomy
The cornea is the transparent tissue that covers the front part of the eye and focuses light. There are many surgeries that can be done to the cornea. All of the surgeries have similar sounding names since they use the prefix kerato-, meaning cornea. Here’s a breakdown of corneal surgeries:
- Keratotomy: A small cut into the cornea
- Keratomileusis: Reshaping of the cornea, usually by laser
- Keratectomy: Removal of part of the cornea
- Keratoplasty: Removal and replacement of the cornea with donor tissue (ie corneal transplant)
The quality of your vision depends on how well your cornea focuses light. If the cornea is unable to focus light onto the back of the eye, known as the retina, then the vision will be blurry. A refractive error occurs when light is not focused onto the retina. One such refractive error is nearsightedness. Nearsightedness happens when the cornea focuses light in front of the retina, instead of directly onto it. A keratotomy surgery is done to perfectly shape the cornea so that it bends light properly. Keratotomy is an eye surgery used to correct refractive errors such as mild nearsightedness or astigmatism.
Types of Keratotomy
- Radial Keratotomy
Radial keratotomy is a surgery used to correct mild amounts of nearsightedness, or myopia. The aim of radial keratotomy is to flatten the central part of the cornea. The surgery is done by making eight small cuts, or incisions, into the cornea. These cuts are made in the peripheral areas of the cornea. The eight cuts form a star shaped pattern circumferentially around the cornea. Radial keratotomy was the first refractive surgical procedure to gain popularity in North America. However, it was gradually replaced by photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK). Nowadays, radial keratotomy refractive surgery is rarely performed.
- Astigmatic Keratotomy
This surgery is used to correct astigmatism. Astigmatism is a refractive error in which the cornea is not perfectly round, so it has two different prescription powers. Astigmatism is not an eye disease, but rather a ‘focusing’ issue similar to nearsightedness or farsightedness. Astigmatic keratotomy is similar to radial keratotomy, but the cuts made into the cornea are in a curved pattern. Astigmatic keratotomy is usually only carried out alongside cataract surgery. Making small cuts into the cornea flattens its shape and decreases low amounts of astigmatism.
Complications Of Keratotomy
Keratotomy surgery complications include:
- Pain
A moderate amount of eye discomfort may be experienced in the days following surgery.
- Light Sensitivity
Light sensitivity, known as photophobia, happens for two to four weeks after the surgery. It occurs due to mild inflammation. Eye drops are prescribed to minimize the inflammation. Wearing sunglasses helps with glare and light sensitivity as well.
- Corneal Damage
The surface of the eye may become superficially damaged or eroded from the blade used in the keratotomy. The cornea’s surface usually regenerates itself within a week and this damage goes away.
- Blurry Vision
In the first few months following keratotomy, some patients may experience fluctuations in vision. The area around the wound may swell, which affects the vision. The prescription gradually stabilizes and the vision becomes clear as the swelling goes down.
