Arcuate keratotomy (AK) is a short refractive procedure that reduces astigmatism by placing precise curved incisions in the outer cornea, letting the eye's surface relax into a rounder, more focused shape. At our partner clinics, femtosecond laser-guided AK costs from £1,200 per eye, all-inclusive of the consultant, corneal scans, the procedure and follow-up. It is especially useful for low to moderate corneal astigmatism, and is often performed at the same time as cataract surgery or lens replacement to fine-tune the result. For higher astigmatism, a toric intraocular lens or laser eye surgery may be more suitable — your consultation determines the best route.
What is astigmatism and how does AK correct it?
Astigmatism is a very common refractive error in which the cornea is shaped more like a rugby ball than a football, curving more steeply in one direction than the other. Instead of focusing light to a single point, the eye focuses it to two, producing blurred or distorted vision at all distances and, often, eye strain and headaches.
Arcuate keratotomy works by placing one or two arc-shaped incisions in the steepest meridian of the peripheral cornea. These relaxing incisions allow the steep axis to flatten slightly and the flat axis to steepen, evening out the curvature so light focuses more precisely. When guided by a femtosecond laser, the depth, length and position of each incision are computer-controlled for a high degree of precision and reproducibility.
Signs astigmatism may be affecting you
- Blurred or distorted vision at both near and distance
- Eye strain and headaches, especially after focusing tasks
- Squinting to try to see more clearly
- Glare and halos around lights at night
- Difficulty with fine detail such as reading or screen work
- Residual astigmatism after cataract surgery limiting your result
Tired of astigmatism holding your vision back? A refractive assessment with corneal mapping shows exactly which correction suits your eyes.
Book a refractive assessmentYour options for correcting astigmatism
Arcuate keratotomy is one of several proven ways to reduce astigmatism. The best choice depends on how much astigmatism you have, whether you also have cataracts, and your overall prescription.
If you are having cataract or lens replacement surgery, correcting astigmatism at the same time — with AK or a toric lens — gives the sharpest possible result and the greatest freedom from glasses.
What happens during arcuate keratotomy
Arcuate keratotomy is a short procedure performed under local anaesthetic eye drops. You stay awake and feel no pain, only light pressure. It takes around 10 to 15 minutes per eye, whether performed alone or as part of cataract or lens surgery.
- Detailed corneal topography and biometry map the exact axis and amount of your astigmatism and plan the incisions.
- Numbing drops anaesthetise the eye and the surface is cleaned.
- The surgeon creates precise arc-shaped relaxing incisions in the peripheral cornea — with a femtosecond laser for computer-guided accuracy, or by hand with a calibrated blade.
- Where combined with lens surgery, the cataract or lens exchange is completed in the same sitting.
- The eye is protected and you rest briefly before going home the same day.
Recovery week-by-week
Recovery from AK is quick, though vision fluctuates for a short period as the cornea settles into its new shape. Here is what to expect:
Day of surgery
Vision is a little hazy and the eye may feel gritty and watery as the drops wear off. An eye shield is worn for the first night. Drops begin.
Days 1–3
Comfort returns and vision starts to clear. Mild light sensitivity is normal. Avoid rubbing the eye and follow your drop schedule.
Week 1
First review. Most people are back to work and driving. Vision continues to sharpen as the corneal curvature stabilises.
Weeks 2–6
Astigmatism correction settles and vision steadies. Any new glasses prescription, if needed, is finalised once the cornea is stable.
Beyond six weeks
Your refractive result is settled. Many patients enjoy markedly reduced astigmatism and less reliance on glasses for distance.
Arcuate keratotomy cost in the UK
Our prices are all-inclusive: consultation, corneal scans and biometry, the procedure itself, theatre and surgeon fees, post-op drops and follow-up reviews. There are no hidden extras.
- Femtosecond arcuate keratotomy: from £1,200 per eye.
- Manual arcuate keratotomy: from £950 per eye, or bundled when performed during cataract/lens surgery.
- Toric IOL alternative: from £3,400 per eye at lens surgery (see the toric lens cost guide).
- Laser alternative: from £2,400 per eye (see the laser astigmatism cost guide).
- Insurance: where astigmatism correction is clinically indicated it may be covered by Bupa, AXA, Aviva, Vitality and WPA. Finance: 0% options available.
For the full range of refractive and cataract prices, see our price guides or the cataract surgery cost guide.