Vision After LASIK and Radial Keratometry

Did you have laser eye surgery years ago and now need some help with your vision correction? 

• Are you now starting to need reading glasses?     
• Have you tried disposable contact lenses and struggle with dryness or lens discomfort?     
• Do you experience ghosting or fluctuating vision? 

Why is it more complicated to wear contact lenses now?

The Post surgical eye can come with a list of complications. Some effects are minor and seem to be simply annoying and sadly, others are more severe.

Regular contact lenses are designed to fit the more “average” or “normal” cornea. The lens manufactures have produced lenses accounting for the predictable, more common curves and shapes.

But what if your cornea doesn’t change evenly in the predictable amounts? Yep, this is where you experience substandard vision, poor comfort and frustration.

When fitted with a custom post-operative lens, the lens can now be closely aligned to the unique shape of your cornea, resulting in sharper, more stable vision.

Although LASIK, PRK, and other laser vision correction procedures have a high success rate, they don’t always produce perfect vision for everyone.

The results depend largely on the unique way one’s corneas respond to laser energy and how one’s eyes heal after surgery.

Dry Eye-Often, refractive surgeries may leave you with some dry eye complications. The main cause of this is a decrease in tear production that can cause eye discomfort and blurred vision

.*Almost half of all LASIK patients experience a certain degree of dry eye syndrome. Some patients, particularly those who underwent Radial Keratotomy, may have open incisions in their corneas which never healed. This may cause significant pain and discomfort. _{according to the April 2006 issue of the American Journal of Ophthalmology}.

Post-Refractive Surgery Ectasia-In rare cases, patients will develop post-surgical ectasia, a condition that resembles keratoconus—a progressive eye disorder where the cornea bulges into a shape resembling a cone. Some procedures e.g. LASIK involve removing corneal tissue and reshaping the cornea. This procedure is effective for correcting issues such as nearsightedness, farsightedness, and astigmatism, but it also inherently results in a thinner cornea. Sometimes, and thankfully in very few cases, the corneal thinning combined with internal pressure in the eye can cause expansion or distension of the cornea. In turn, this process results in irregular astigmatism with accompanying blurred and/or distorted vision. Symptoms may include glare, halos and starbursts around headlights, eye strain, and headaches. Conventional eyeglasses are no help, as they do nothing to change corneal irregularities or the vision problems those irregularities cause. RGP lenses are always superior for treating corneal irregularities.

Radial Keratotomy:

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.

Some of these patients later tried LASIK to undo the damage done by RK. Combined, these two types of refractive surgery potentially caused even more vision and fitting complications.

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. This can potentially cause mild to severe light sensitivity or photophobia and require the patient to use dark glasses in order to improve their symptoms.

We have a few ideas on how we can help with this!

Weakened Corneas-The corneal incisions done during RK heal, but those sections of the cornea never regain their full strength. As a result, patients who have undergone RK can potentially have permanently weakened corneas. The extent of the damage depends on the extent of the surgery.

Ocular Infection or Inflammation-RK incisions heal slowly and incompletely. As a result, an eye that has undergone RK is potentially more prone to infection or irritation than an eye that has not. Even something as simple as rubbing 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.

What is Radial Keratotomy?

Radial Keratotomy also known as RK, is a type of refractive surgery meant to correct myopia or nearsightedness. Developed in the 1970s, it was the very first refractive surgical procedure. Since then, RK has largely been rendered obsolete by newer refractive surgeries, such as LASIK and photorefractive keratectomy (PRK). In an RK procedure, the 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. More than two million people went through this surgery in the United States and Canada alone, so RK complications are potentially even more common than once thought.