Limbal Relaxing Incisions and Astigmatic Keratotomy Eye Surgery

Medically Reviewed by Whitney Seltman, OD on November 09, 2022
Written by WebMD Editorial Contributors
3 min read

Astigmatic keratotomy eye surgery -- or AK -- and the more commonly performed limbal relaxing incision, or LRI, surgery are safe and effective. In recent years, AK has been largely replaced by LRI and LASIK.

The cornea of people who have astigmatism is shaped like a football. Astigmatic keratotomy eye surgery corrects astigmatism by making one or two incisions at the steepest part of the cornea. These incisions cause the cornea to relax and take a more rounded shape, thereby reducing astigmatism.

People with mild eyeglass or contact lens prescriptions generally have the most success in obtaining normal vision after astigmatic keratotomy eye surgery. People with more severe astigmatism may still require glasses or contact lenses after astigmatic keratotomy eye surgery.

Limbal relaxing incision eye surgery is a safe and effective way to correct astigmatism and it's often used in conjunction with other vision correction procedures.

There are disadvantages of limbal relaxing incisions, including discomfort (usually mild) that lasts 1 to 2 days.

Although rare, side effects from limbal relaxing incision eye surgery can occur. They may include:

  • Fluctuating vision, especially during the first few months after surgery
  • A weakened cornea, more vulnerable to rupture if hit directly
  • Infection
  • Glare or starburst around lights that can sometimes be permanent
  • Light sensitivity

 

Before deciding on LRI, your medical history will be evaluated, and your eyes will be tested. Likely tests include measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Once you have gone through your evaluation, your surgeon will tell you what to expect before, during, and after surgery and answer any questions you may have. Afterwards, you can schedule an appointment for limbal relaxing incision.

On the day of your eye surgery, eat a light meal before going to the doctor's office, and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you do not feel well that morning, call the doctor's office to determine whether the surgery needs to be postponed.

LRI is done with topical anesthesia put directly into the eye, and the entire procedure generally lasts a maximum of 10 minutes for both eyes. It involves making one or two incisions at the steepest part of the cornea. This causes the cornea's football-shape, which is causing the astigmatism, to relax into a rounded shape for better vision.

 

After LRI, your eye may be sensitive to light for a few hours or feel like there is a foreign object in it. Your doctor will prescribe eye drops for you to prevent infection and inflammation and reduce irritation.

While reduction in the astigmatism is often observed the day after surgery, it generally takes a few weeks before the results stabilize. In cases of severe astigmatism, which can be reduced but not eliminated, new eyeglasses or contact lenses will typically be prescribed a month after surgery.

Often people with astigmatism also have another vision problem, such as farsightedness. For these people, their vision without eyeglasses after the astigmatic keratotomy may get worse at first. To achieve good vision without eyeglasses, a second procedure, such as LASIK may be performed at a later date.