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For many patients who struggled with myopia or astigmatism in the 80s and 90s, radial keratotomy (RK) represented improved visual clarity. At the time, RK was a leading procedure for correcting myopia. The procedure involved making several spoke-like incisions into the cornea to flatten it. While many patients achieved clear vision initially, the long-term effects of the permanent surgical changes have persisted.
In the decades following the popularity of RK surgery, many patients started experiencing post-RK dry eye. Without treatment, chronic dry eye can have serious consequences for vision and eye health. Fortunately, there are treatment options that can help RK patients protect their vulnerable eyes and regain lost acuity with specialized contact lens solutions, such as scleral lenses. This blog explores RK and how scleral lenses can support patients with dry eye after RK surgery.
What Is Radial Keratotomy?
Radial Keratotomy alters the corneal shape and nerve function of the eyes in an unpredictable way. The RK procedure involves several deep incisions that penetrate the cornea to roughly 90% of its depth. While RK successfully alters corneal curvature, it also disrupts corneal nerves, which can be supported with protective lenses. The nerves are essential for maintaining eye health because they transmit signals to the brain that regulate tear production.
Dry eye Miami after RK surgery is common because the eye’s natural ability to signal for hydration was compromised. The neurological disruption between the eyes and the brain is the primary cause of dry eye in post-RK patients. Furthermore, the incisions made are irreversible, and the permanent changes can lead to corneal ectasia over time in many cases. Scleral lenses help stabilize the cornea by vaulting over irregularities.
What Makes Post-RK Dry Eye Unique?
Managing dry eye after RK surgery benefits from specialized management customized to corneal changes. In a healthy eye, the eyelid smoothly distributes a layer of tears across the uniform corneal surface with each blink. However, as the eyelid moves across the scarred post-RK eye, the tear film breaks up, leaving areas of the cornea exposed to the air. Localized dry spots cause the stinging, burning, and fluctuating vision shared by RK patients.
When post-radial keratotomy dry eye isn’t managed, it increases the risk of complications like persistent epithelial defects and further corneal instability. Many patients also experience changes in vision and comfort throughout the day. The fluctuations occur because the weakened cornea’s shape changes based on hydration levels and intraocular pressure. Post-RK patients often report fluctuating vision, which worsens later in the day.
The Limitations of Traditional Post-Surgical Dry Eye Management
Many patients looking for post-RK eye care initially rely on over-the-counter artificial tears or lubricating drops. While these products can provide temporary relief, they don’t address the root cause of dry eye. Scleral lenses can protect the entire ocular surface. Because the post-surgical cornea is so irregular, eye drops tend to pool in the incision valleys while the peaks remain dry. Inconsistent lubrication means that, despite frequent use of drops, patients still experience chronic dry eye symptoms.
Traditional soft contact lenses are also not a viable option for post-RK patients. Standard contact lenses are designed to drape over the cornea. Yet, an irregular surface interferes with the stability of soft lenses. Furthermore, when soft lenses don’t lie flat against the cornea, they may not conform well, potentially leading to discomfort or reduced oxygen flow, not to mention poor and fluctuation vision. RK patients require a more advanced, long-term solution for eye protection and vision correction.
Advanced Post-RK Dry Eye Treatment With Scleral Lenses
The most effective advanced vision correction and dry eye treatment after RK surgery is scleral lenses. Scleral lenses are specialty, large-diameter, rigid, gas-permeable lenses that rest on the sclera, the white, less sensitive part of the eye, instead of the cornea. By vaulting over the irregular corneal surface, scleral lenses create a protective chamber between the cornea and the lens. The chamber is then filled with sterile saline to provide moisture and improve vision. Custom scleral lens fittings ensure optimal vault and hydration for post-RK eyes.
Once the lens is in place, the cornea is fully submerged in the fluid reservoir. The saline acts as a liquid bandage, shielding the scarred cornea from the friction of the eyelids. Scleral lenses are an advanced dry eye treatment we can provide after RK surgery to restore comfort and visual acuity. By keeping the ocular surface hydrated throughout the day, scleral lenses also support corneal stability and safeguard long-term eye health.
Restoring Visual Clarity and Supporting Long-Term Eye Health
Beyond the physical relief of corneal sensitivity after RK surgery, scleral lenses are also a highly effective option for restoring vision. Because the saline-filled chamber masks the corneal irregularities of the incisions, it creates a perfectly smooth optical surface. Light is refracted through the uniform curve of the lens rather than the distorted cornea, reducing the glare, halos, and ghosting that are common among RK patients.
Our approach to chronic dry eye post-RK builds on the procedure’s outcomes. However, scleral lenses can protect long-term eye health, prevent further corneal damage, and maintain clear, stable vision. Scleral lenses allow patients to break the cycle of constant eyedrop use and adopt a sustainable management plan. Our goal is to improve comfort and quality of life for all our patients.
Personalized Care for Post-RK Patients
Patients enjoy sustainable relief without constant drops. At Miami Contact Lens Institute, we specialize in providing innovative non-surgical vision correction for patients who have exhausted traditional options. We understand the frustrations of post-surgical dry eye management, but we are here to help you. We offer ongoing professional guidance to our patients, starting with a comprehensive eye exam and a customized treatment plan.
Contact us to schedule your consultation at Miami Contact Lens Institute today for a comprehensive evaluation and personalized scleral lens fitting.
