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Understanding Radial Keratotomy Complications
Radial Keratotomy, often called RK, was a refractive surgery used before modern LASIK to reduce nearsightedness and astigmatism. The procedure involved making spoke-like incisions in the cornea to flatten its shape. Years later, many RK patients experience unstable vision because the cornea can continue to change, weaken, or become irregular over time.
At Eye Freedom in Miami, Dr. Edward Boshnick evaluates patients with post-RK vision problems using advanced corneal diagnostics and custom specialty lens design. Many patients who cannot see clearly with glasses or standard contact lenses may benefit from scleral lenses designed for an irregular cornea.
Common RK complications can include:
- Loss of Best Corrected Visual Acuity (BCVA): Even with correction, patients have noticed a drastic decrease in their BCVA, significantly impacting their quality of life.
- Double or Triple Vision (Diplopia or Polyopia): This challenging symptom can hinder everyday activities, causing distress and inconvenience.
- Irregular Astigmatism: Due to unpredictable corneal reshaping following RK, patients often experience distorted vision caused by irregular astigmatism.
- Unstable or Fluctuating Vision: As the cornea heals and adjusts post-surgery, vision can become inconsistent, varying from day to day or even throughout the day.
- Severe Dry Eye: RK may lead to reduced tear production, causing discomfort, irritation, and an increased risk of eye infections.
- Halos, Glare, and Reduced Night Vision: This effect can make night driving extremely difficult and limit activities in low-light conditions.
- Permanently Open Incisions: This risk can result in complications such as increased susceptibility to ocular infections and trauma.
- Recurrent Ocular Infections and Inflammations: These conditions can cause further damage if not managed promptly and effectively.
- The Eventual Need for Corneal Transplant Surgery: In severe cases, the cornea might become so damaged that it needs to be replaced.
Some RK patients later underwent additional refractive procedures, including LASIK or PRK, in an attempt to improve vision. Additional surgery on an already weakened or irregular cornea can sometimes make the optical problem more complex, which is why a detailed specialty lens evaluation is often an important step before considering more invasive options.
Scleral lenses are often helpful for post-RK eyes because they vault over the cornea instead of resting directly on the incision pattern. The lens creates a smooth optical surface while a preservative-free saline reservoir fills the space between the lens and the eye. This can improve visual stability, comfort, and ocular surface hydration.
Dr. Boshnick may use technologies such as computerized corneal topography and wavefront-guided scleral lens design when needed to understand the corneal shape and higher-order aberrations contributing to glare, halos, ghosting, or fluctuating vision.
If RK complications are affecting your vision or comfort, contact Eye Freedom in Miami to schedule a consultation. Patients with broader post-surgical concerns may also find our page on post-surgical vision loss helpful.
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Frequently Asked Questions
Radial Keratotomy (RK) is a refractive surgical procedure that was commonly used to correct myopia (nearsightedness) and astigmatism. It involved creating radial incisions in the cornea to flatten it, thereby improving vision.
The complications from RK often arise due to the unpredictable nature of corneal healing post-surgery, leading to conditions like irregular astigmatism and unstable or fluctuating vision. Additionally, the incisions can permanently weaken the cornea and lead to severe dry eye, recurrent ocular infections, and other complications.
Specialty lenses like Scleral lenses and Synergeyes lenses can greatly improve visual acuity and comfort. Scleral lenses create a protective barrier filled with a special liquid over the cornea, aiding in healing and hydration. Synergeyes lenses are hybrid lenses that combine a rigid gas-permeable center with a soft peripheral ring, ensuring both clear vision and comfort.
While some surgical options like LASIK and PRK have been used to correct post-RK complications, they often lead to additional complications. Non-invasive solutions like specialty lenses are recommended to avoid further risks associated with surgical procedures.
Scleral lenses vault over the compromised cornea and rest on the sclera, providing a protective barrier between the lens and the cornea. This aids in corneal healing, provides optimal vision, and enhances comfort by keeping the cornea hydrated.
Synergeyes lenses are hybrid lenses that combine a rigid gas-permeable center with a soft peripheral ring. The rigid center corrects vision, while the soft ring ensures comfort. These lenses fit comfortably over irregular corneas and provide a smooth optical surface, helping to correct irregular astigmatism.
While many patients have experienced significant improvements in visual acuity and ocular comfort with these lenses, the outcome can depend on individual circumstances. It’s recommended to consult with Dr Boshnick to determine the best solution for your specific needs.
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Dr. Boshnick
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7800 Sw 87 Ave Suite B-270
Miami, Florida 33173
