Refractive Surgery Blog

A patient I have followed over the past twenty years recently came in with an all too common problem - his vision had deteriorated gradually after having had radial keratotomy (RK) in the 1980s. Allan had a multiple cut RK along with an AK (astigmatic keratotomy) about twenty-five years ago when living in California. Through the years I have fit him with a variety of different contact lenses to improve his vision but even a rigid lens was difficult to fit as his cornea was so flat. The result was that his vision was inconsistent and he was never entirely happy with his compromised vision. Now, Allan's vision had become so abnormal due to the shifting of his cornea that he was no longer correctable with glasses or contact lenses. The question was: Now what?

RK was the first popular surgical approach used to correct both myopia and astigmatism. It was the rage in the 1980s and into the early 1990s before lasik became available in the United States. The way it worked was partial thickness radial cuts were made into the cornea. The effect was to weaken the peripheral cornea so that the normal intraocular pressure that was constantly pushing out, preferentially influenced the weakened area of the cornea that provided the least resistance. The result was the peripheral conea bulged and the central cornea flattend to give the desired effect. The problem was that over the years, the central cornea continued to gradually flatten and patients gradually became farsighted.

Over the past several years I have has success treating these refractive problems by performing either hyperoptic lasik under the RK cuts or PRK over the cuts in an attempt to even out the corneal curvature. In this case I recommended lasik to Allan with special emphasis on treating the large amount of astigmatism that had developed. Allan was nervous about this but decided to procede as he felt he had little to lose. The procedure went perfectly and Allan had 20/20 vision on the first post-operative day.

Post-RK refractive surgery works. If your having farsighted problems years after your RK, give us a call.

Labels: LASIK, PRK, RK