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Radial Keratotomy (RK)

Radial Keratotomy (often abbreviated RK) is a type of refractive surgery meant to correct myopia or nearsightedness. Developed in the 1970s in Russia, RK was the very first refractive surgical procedure to gain ground in North America. Since then, RK has largely been rendered obsolete by newer refractive surgeries, such as LASIK and photorefractive keratectomy (PRK).

How Does Radial Keratotomy Work?

In an RK procedure, a surgeon makes small but deep incisions in the cornea with the goal of flattening it. Since myopia often results from an excessive curvature of the cornea, this procedure will ideally help to reduce issues like nearsightedness and astigmatism.

Often, surgeons will perform RK on one eye and then wait up to six weeks before performing surgery on the second eye. This delay allows the surgeon to monitor the first eye and record the results of the surgery. The results of the surgery on the first eye will often influence how the surgeon performs the surgery on the second eye. In the meantime, the patient will be fitted for contact lenses for the uncorrected eye to ensure more equal and consistent vision between the eyes.

Complications of RK

While many patients praised the effects of RK in the early days, long-term results of the surgery have not all been as positive. Many RK patients suffer from permanent vision damage and other long-term complications. The complications include:

  • Weakened corneas: The corneal incisions done during RK heal in the wake of the surgery, but those sections of the cornea never regain their full strength. As a result, patients who have undergone RK often deal with permanently weakened corneas. The extent of the damage depends on the extent of the original surgery. Patients with more severe myopia often require longer and deeper incisions to correct the issue. These patients suffer the worst symptoms with weakened corneas. 
  • Ocular infections or inflammation: RK incisions heal slowly and incompletely. As a result, an eye that has undergone RK is more prone to infection or irritation than an eye that has not. Even minor trauma or contact—such as rubbing of the eyes—can irritate the incision scars and lead to bacterial infections. Irritation or trauma can also cause blood vessels to grow into the incisions, which can permanently damage or destroy the cornea. 
  • Risk of rupture: Because RK incisions never fully heal, they leave the eye more vulnerable to rupture. Any trauma can cause the incisions to rupture and reopen, leading to infection, astigmatism, and other serious problems. Patients who have gone through RK are strongly encouraged to wear protective eyewear during contact sports or any other activities where their eyes may be vulnerable. 
  • Irregular astigmatism: Because RK results are often unpredictable in the way they heal long term, the patient may end up with irregular astigmatism and require specialty contact lenses in order to achieve their visual potential. 
  • Light sensitivity: Some patients who undergo RK can have the incisions extending into their pupil or visual axis. They may cause mild to severe light sensitivity or photophobia and require the patient to use dark glasses in order to improve their symptoms. 

In addition to these complications and risks, RK patients often complain of dry eye, double or triple vision, fluctuations in vision quality, halos, glare, reduced indoor or night vision, and even depression. Studies have also shown that, over time, patients who have undergone RK to correct nearsightedness gradually shift toward farsightedness.

Treating RK Complications

At Miami Contact Lens Institute, we frequently treat patients for complications from RK. More than two million people went through this surgery in the United States and Canada alone, so RK complications tend to be common. Some of these patients later tried LASIK to undo the damage done by RK. Combined, these two types of refractive surgery often cause even more severe issues than RK alone.

By using scleral lenses, we can help patients restore their vision. Scleral lenses are large contact lenses that rest on the sclera (the white of the eye) and protect the cornea with a fluid-filled vault. At Miami Contact Lens Institute, we custom-make scleral lenses for each patient, fitting the lens to ensure the cornea is constantly hydrated and protected. The fluid-filled tear reservoir helps compensate for irregularities on the surface of the cornea—including scars from RK incisions—thereby providing improved vision. Finally, because our lenses are permeable to oxygen, they are comfortable, leaving the patient with little to no irritation or sensation of having something in their eye.

Am I a Good Candidate for Scleral Contact Lenses?

If you have previously gone through RK surgery, scleral lenses might be able to help you manage your vision problems, protect your corneas, and promote more complete healing of your incisions. To learn more about how scleral lenses can help you get back to a normal life after an RK procedure, give us a call at (305) 814-2299 or contact us by filling up a form. 

We are located at 2627 NE 203rd St #116, Aventura, FL 33180. Call us today to schedule an eye examination.

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