Conductive Keratoplasty (CK) Tips

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Compare CK, LASEK and LASIK.

CK vs. LASEK and LASIK

CK is a procedure that uses radio waves to steepen the cornea. This procedure usually takes less than five minutes and is used to treat presbyopia and farsightedness. Rather than using cutting to complete the procedure, CK utilizes radio waves and heat.

LASEK is a procedure that is fairly new. It is commonly used for people who have too thin of corneas to be suitable for LASIK. It was created to lessen the complications that may occur when the flap created by LASIK is not thick enough. The outer layer of the cornea is cut using a fine blade called a trephine.

LASIK is the most common of all laser eye surgeries. The procedure involves cutting the cornea with a microkeratome or the newly approved Intralase. Both nearsighted and farsighted people may be eligible for LASIK.

   
What is Lighttouch Technology?

Does CK With Lighttouch Show More Stable Results?

Stability of CK results are improving with the introduction of new technology. An example of this new technology is NearVision CK with Lighttouch.

This Lighttouch technology allows for less compression on cornea, with the compression either being reduced or eliminated altogether. This technique also lessens the stretching of the cornea that comes with traditional CK. This new technology has shown to have stable results for months and years after the surgery with better and more predictable outcomes. Talk to your doctor about the new Lighttouch technology and learn about all aspects of CK before deciding on the procedure.

   
Should I be able to read fine print perfectly after CK?

Read the Fine Print on CK

If you want to read legal documents with small print after having conductive keratoplasty, read your CK eye surgeon's disclaimer first.

While 87 percent of patients could read phone book-sized print (and could see long distance) after the 2004 FDA clinical trial of CK eye surgery to treat presbyopia, some patients can't read fine print with complete clarity. Some patients may still need reading glasses for books, but results in any surgery may vary from patient to patient.

Your ophthalmologist may tell you that you'll need to hang on to your reading glasses two years after the procedure. You can do that to hedge your bets, but your corneas may be stable five, seven or ten years from now. Again, conductive keratoplasty results do depend on the individual patient.

   
I've heard that CK sacrifices distance vision in one eye, is this true?

CK and Distance Vision

You want to be able to read that great novel up close without your glasses, but your CK eye surgeon says that conductive keratoplasty will diminish your distance vision in your non-dominant eye, or the eye that's not primarily focusing on this text right now.

CK eye surgery is designed to help you achieve monovision, in which one eye is corrected for distance and one for near vision. If you have healthy eyes but need glasses to see close objects or perform close work, your CK eye doctor will induce myopia, or nearsightedness, in your eye. This may mean that, for a time, your non-dominant eye won't be able to see the title of a book or the print on the computer screen from across the room.

While the effects of CK are permanent, the loss of distance vision usually diminishes with time.

Tip: If you're willing to sacrifice distance vision while driving to be able to read Shakespeare, doctors recommend that you have another form of refractive surgery to correct any results that you're not satisfied with. Side effects or visual glitches from CK are usually temporary.

   
I've heard that vision correction from CK is temporary, is this true?

CK: Temporary or Lasting?

Your CK eye surgeon advises you that while the 20/16 uncorrected vision you regain is permanent with LASIK or LASEK, CK procedures have a risk of regression.

Conductive keratoplasty is a temporary procedure, and since ageing of the eyes isn't cureable, your eyes will revert to your pre-CK eye surgery levels, so don't throw away your reading glasses. However, your wise CK eye surgeon will tell you that CK technology has improved to achieve a more stable refraction since 2002, when the FDA approved the procedure to treat hyperopia, and 2004, when the FDA approved conductive keratoplasty to treat presbyopia.

Patient tip: Ask your ophthalmologist what percent of patients experienced regression and had to have corrections or enhancements after CK.

If you expect that your vision will instantly stabilize, your expectations are too high. CK is successful and offers only temporary discomfort, but it's not an instantaneous procedure.

   
How does CK work?

CK Technical Specs

Why is CK so non-invasive as opposed to other forms of vision correction? You know the answer: radio waves. But how does the same medium that carries your kids' hip-hop music hits help your vision?

Your CK eye surgeon will use dye to plot up to 32 treatment points, after your eye has been numbed with anesthetic eye drops. The conductive keratoplasty probe will radiate the treatment points with heat from radio frequency waves in concentrated bursts.

What do you do while CK radio waves correct your vision? You recline comfortably in an eye exam chair, just as you would for your regular eye exam, and focus on the light from a microscope. Your eyelids will be propped open with a speculum-like tool that helps ground the radio frequency and acts as a return path while the radio waves are bouncing around.

Sound complex? It isn't--the procedure takes 15 minutes, and you can have both eyes treated at once if the CK is performed to correct hyperopia. Remember that if you have CK to treat hyperopia, your range needs to be between +0.75 and +3.25 diopters of refractive error and at most +.075 diopters astigmatism.

In any case, you'll find that radio waves simplify eye surgery and make vision correction after 40 easier.

   
Is a changing eye prescription a problem with CK?

Changing Eye Prescription

In most guidelines for refractive surgery, you'll find that an eye surgeon requires you to have had a stable prescription for at least a year. You also know that surgeons are usually concerned that fluctuations in eye prescriptions will cause regression.

You think that a changing prescription won't be a problem--you're 50 and older, you're stable and mature.

All bets are off with presbyopia and hyperopia, which get worse as you age because your eyes age, so you could have diopters of +2.00 one year. Two years later, a diagnostic eye exam could reveal that your prescription is +4.00 diopters. CK requires you to have a stable eye prescription.

Yet some CK eye surgeons say that you can have conductive keratoplasty if your prescription is likely to change. Your presbyopia will probably level out to a low-range aberration, +2.00 to +2.25 diopters.

Prescription change, however, is only acceptable after you have the procedure, when your CK eye surgeon can perform enhancements. Your prescription needs to be stable for at least a year before any conductive keratoplasty procedure.

   
Why is CK more expensive in the long run?

How Can CK Get Expensive?

Conductive keratoplasty (CK) is a great choice for baby boomers who wish to correct their vision and rid themselves of reading glasses. What makes this choice actually more expensive than some of the other laser vision correction procedures?

One procedure of CK is actually less expensive than one of the other types of laser eye surgeries. Therefore, many people see CK as a cheaper and easier laser eye surgery.

Typically, the procedure costs around $1,500 for one eye and since CK is considered an elective or a cosmetic surgery, it usually isn't covered under insurance plans. CK is an ongoing process because the effects of the procedure are not permanent, and must be repeated every three to five years.

However, CK is different and more appealing to patients because there is no cutting involved and no tissue removed. Talk to your doctor about the best approach for your eye correction surgery, and find out if CK is right for you.

   
I'm over 40, what eye surgery options do I have?

CK Candidacy

You've had all your children and are windsurfing with ease...unfortunately, you have presbyopia or hyperopia, and your contacts slip when you're cresting a wave.

Check with a conductive keratoplasty eye surgeon. CK is designed for people over 40 with presbyopia, a condition that prevents you from focusing on near objects. CK eye surgery isn't invasive, and doesn't involve blurring of distance vision.

The probe used in conductive keratoplasty improves the curvature by shrinking the collagen in your eye, tightening the cornea and lengthening your eyeball. You'll typically have the CK procedure done on one eye.

If your eye is healthy, your eyeglass prescription has been stable for at least a year, you don't have strabismus, keloid scarring, diabetes, glaucoma, or autoimmune disorders, and if you're not planning to get pregnant again, you're an excellent candidate for CK eye surgery. See, being over 40 does have its advantages!

   
Why is conductive keratoplasty (CK) not an appropriate procedure for those with myopia?

CK Not Okay For Myopia?

Conductive Keratoplasty (CK) is a procedure commonly done in a doctor's office. It does not require you to go to an outpatient surgical center. It is a very quick procedure, taking about three minutes.

The goal of CK is to reshape the cornea by making it steeper. CK is great for patients who are older than 40 and need glasses for reading purposes. Myopia is considered to be a vision problem often referred to as nearsightedness.

Unfortunately, to correct myopia, the cornea must be flattened. CK is a procedure that bends the cornea rather than flattens it. Therefore, conductive keratoplasty is not a procedure that will improve the vision of those with myopia, or nearsightedness.

   
Why do I have to wear contact lenses if I'm having CK?

Contacts and CK

Your ophthalmologist wants you to wear special monovision contact lenses. But you thought the whole point of conductive keratoplasty was to get rid of the contacts. What gives?

CK eye surgery typically corrects presbyopia by creating monovision, in which one eye sees distance and one eye sees close-up. Contact lenses do the same thing. Fortunately, CK achieves better results--a study done at the Unversity of Kansas tested presbyopic patients 50 and over that had 20/20 uncorrected vision and disliked wearing reading glasses. These patients achieved better distance and near vision with CK rather than contacts.

However, don't think you've said adios to contacts just yet. Sometimes in CK eye surgery, surgeons will treat the non-dominant eye, or the eye that doesn't do the work of focusing on objects, so that it sees up close, while the dominant eye sees distance. Your eyes may not adjust well, which is why your CK eye surgeon will test you with special contact lenses that produce the effects of monovision. Test lenses may either:

* correct for near vision in one eye and far in the other, and be worn for a trial period before the surgery.

* function as a one-shot test of your dominant eye to make sure your distance vision will be unaffected--note that the surgeon will use a single lens for this.

This is just one of the diagnostic tests your CK eye surgeon will perform. You'll also need your eyes evaluated by a diagnostic instrument called a corneal topographer. The contact lenses and the corneal exam will help your doctor give you the results you want.

You may, however, have to wear contact lens bandages to diminish the pain. Patients choose to accept the special contacts so they can be free of inserting those regular contacts every day.

   
Is CK approved by the FDA?

CK and The FDA

The Food and Drug Administration (FDA) approved conductive keroplasty in 2004 as a safe procedure to treat mild to moderate hyperopia. It is also being studied internationally in clinical trials to treat astigmatism. At this time, CK is FDA approved as a safe procedure for those who are appropriate candidates for the procedure. You should speak with your doctor or eye surgeon about the benefits of CK or other laser eye procedures that may enhance your vision.

   
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