Radial Keratotomy: Slice & Shape to VISION!
Many of you have inquired of me regarding Radial Keratotomy so I shall devote this month’s column to what I recently taught at the National Conference for Eye surgeons held in California as a Pending Refractive “Epidemic”
By naming it so; I have alerted eye surgeons to the fact that thousands of patients who have had Radial Keratotomy (RK) in the 1980s are now seeing their vision deteriorate either from a progressive farsightedness over time or associated aging situations like cataracts.
Patients with previous RK are presenting with a challenging situation in eye surgery not only because of surgical complexity but also due to patient expectations as people who had these surgeries are typically “Early Adapters”.
Fortunately, with technology today, these patients can once again see without glasses.
Radial keratotomy (RK) is a type of eye surgery used to correct Myopia (nearsightedness). It works by changing the shape of the cornea (Flattens the shape) -the transparent part of the eye that covers the iris and the pupil.
History of RK dates back to 1936n when Japanese ophthalmologist Tsutomu Sato applied sharp slits in the cornea. In 1974, Svyatoslav Fyodorov in Russia removed glass from the eye of a boy who had been in an accident and shattered his glasses. When Dr. Fyodorov performed an operation resulting in numerous radial incisions like the spokes of a wheel on the cornea, the boy’s vision had improved and he did not need glasses anymore. A diamond knife was invented to replicate this technique successfully and many American eye surgeons journeyed to Moscow to learn this surgery and later modified it to a safer and more accurate procedure introducing it in the USA in 1978.
RK successfully treated people with low to moderate myopia and could also be paired with specific incisions to correct astigmatism.
With the advent of Lasik in 1995, RK was slowly relegated to history simply because, Lasik is generally more safer, predictable and accurate since it involved the micron-presicion Excimer Laser rather than hand held blades as in RK.
Ten year study of RK patients shows that these patients who were nearsighted (with steep corneas) before RK surgery, over time undergo continued flattening of their corneas so they become farsighted. Since this happens when most of them have become farsighted with age for reading; it is a double whammy.
These patients can be corrected with Advanced Lasik techniques today
In some patients despite a well done RK surgery, normal aging and cataracts affect vision and today, even these patients can be helped with Laser Cataract techniques and new generation Lens implants.
Additionally, new technology that firms up the cornea (Collagen Cross Linking) and prevents it from further flattening can be used in conjunction with Lasik or cataract surgery.
Thus, patients who have had RK surgery and enjoyed their vision freedom need not despair. Ask your eye doctor for your options and get back to the Glasses-free lifestyle you Once enjoyed- Once again!