Dr. Edward Boshnick - Radial Keratotomy & Scleral Lenses

Understanding Radial Keratotomy Complications

Radial Keratotomy (RK) emerged in the 1970s as an innovative refractive eye surgery to correct myopia (nearsightedness) and astigmatism. Over the subsequent decades, RK became a globally accepted procedure, with over a million surgeries performed in the United States alone.

The surgical technique of RK involved the formation of spoke-like incisions deep within the cornea to flatten it, thus correcting refractive errors. However, with the passage of time, unforeseen complications of RK started to unfold, often emerging years post-surgery. The most common complications of RK 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.

In an attempt to manage these complications, many patients underwent additional refractive surgeries, including LASIK. However, these subsequent surgeries have often led to even more complications, sometimes necessitating corneal transplants.

Fortunately, for those dealing with complications from RK, there is light at the end of the tunnel. Cutting-edge advancements in lens technologies offer an effective and non-invasive solution. Specialty lenses, such as Scleral lenses and Synergeyes lenses, have shown impressive results in addressing the vision challenges posed by post-RK complications.

Scleral lenses, named after the sclera (the white part of the eye), are large gas permeable lenses that cover the entire corneal surface and rest on the sclera. They create a saline-filled reservoir between the lens and the cornea, providing hydration, comfort, and promoting corneal healing.

Synergeyes lenses are a type of hybrid lens. These lenses have a rigid, gas permeable center that corrects vision, surrounded by a soft peripheral ring that ensures comfort. These lenses are particularly effective in cases of irregular astigmatism, as they provide a smooth and regular surface in front of the cornea.

These lens technologies have transformed the lives of many post-RK patients. In our specialty lens practice, virtually every patient who has made the switch to these advanced lens options has seen a significant improvement in both visual acuity and ocular comfort.

Your Vision, Our Priority:
Schedule Your Consultation Now

Book Appointment

Frequently Asked Questions

What is Radial Keratotomy (RK)?

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.

Why are there so many complications associated with RK?

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.

How can specialty lenses help with post-RK 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.

Are there any surgical options to correct post-RK complications?

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.

What are the benefits of Scleral lenses for post-RK patients?

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.

How do Synergeyes lenses work for post-RK patients?

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.

Can every patient with RK complications benefit from these specialty lenses?

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.