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Improving Vision After Radial Keratotomy (RK)

The goal of this page is to discuss on methods and limitations in Improving Vision After Radial Keratotomy (RK)

Did you have RK done 15 to 35 years ago? Your radial Keratotomy or RK surgeon is no longer likely to be in practice. You may have resorted to wearing reading glasses and even distance glasses. Your vision may be fluctuating causing you to carry multiple glasses. Mornings may be better for distance and evenings for reading. Speaking of evenings hows the glare?

If you have had radial keratotomy and are looking for visual solutions you have come to the right page. Dr. Khanna is an authority on rehabilitating eyes after radial keratotomy. He is the first person in the world to publish on results of Pi (Presbyopic Implants). International colleagues attend his lecture on this subject in Boston. Many patients have benefited with his knowledge and expertise.


What is Refractive Surgery After Radial Keratotomy (RK)?

Radial Keratototmy (RK) was a procedure for treating nearsightedness. It was developed Russia by ophthalmologist named Fyodrov. RK involved making radial cuts from around the pupillary zone to periphery of the cornea. The cuts or incisions worked by flattening the corneal curvature, which is too steep in myopia patients. Top RK surgeons made Radial incisions at 90 to 95 % depth of the cornea. They measured the depth with ultrasound pachymetry.

Perhaps you had RK when there was no other option. It probably worked for many years and then gradually, over time, reading became a problem. Now perhaps you are even wearing distance glasses, or astigmatism is bothering you. The wonderful surgeon who improved your vision is now retired. So what do you do now?

Dr. Khanna has helped many patients improve their sight after Radial Keratotomy (RK).

Why RK Was Discontinued in the U.S.

RK involved making vertical incisions in the cornea, penetrating up to 95% percent of your corneal depth. The number of incisions ranged from two to eight depending on your vision prescription. Some surgeons were more aggressive and made 16 or even up to 64 cuts on the cornea. Some surgeons just made a fixed depth cut irrespective of the thickness of the cornea.

We now know that these incisions weaken your cornea. The eyes are filled with fluid that exerts outward pressure, and a weakened cornea may not be able to keep its curvature against that pressure. This leads to fluctuations in vision between morning and night. Residual astigmatism may also be contributing to glare at night.

The PERK Study

The U.S. National Eye Institute did a ten-year study called the Prospective Evaluation of Radial Keratotomy (PERK) to evaluate the short-term and long-term effectiveness of one of the RK techniques. Researchers concluded that although RK did improve myopia, its effectiveness varied from patient to patient.

It also demonstrated that there was an annual drift towards corneal flattening, which caused the eye to become gradually more farsighted. The results of this study showed that a post-RK eye was permanently unstable, and this led to RK falling out of favor in the U.S.

improving vision after 8 cut RK surgery

Challenges in Operating on Post-RK Eyes

  • The cornea is very flat
  • There is astigmatism or irregular astigmatism
  • The posterior curvature is different
  • The optical zone is small (the area where surgical changes can be made)
  • Ophthalmic diagnostic instruments may not be able to display accurate readings of the cornea
  • IOL (Intraocular Lens, such as Tecnis, ReSTOR or Crystalens) power calculations may also require modifications because of each post-RK cornea being different

Restorative Surgical Methods after RK

Despite the challenges listed above, there are various techniques that can be used to improve vision after Radial Keratotomy. An experienced corneal surgeon like Dr. Khanna can analyze the exact problem and devise a tailor-made treatment plan. Since Dr. Khanna is trained and certified in multiple technologies, he can combine them to improve your unique vision.

Improving Vision After Radial Keratotomy (RK) with Lasers

Dr. Khanna can use idesign laser vision correction for Improving Vision After Radial Keratotomy (RK). It can be used to enlarge the optic zone and fix astigmatism and myopia or hyperopia. idesign laser can be employed as a stand alone procedure if you are in your forties. idesign superlasik can be also used after PIE (presbyopia implant in eye) procedure has been performed.

Lasik is nowdays avoided after RK surgery. The flap may cause the cornea to split in pizza like segments.

PIE to help Improve Vision After Radial Keratotomy (RK)

Rajesh Khanna, M.D., is also skilled in PIE procedure )formerly called Refractive Lens Exchange  surgery). This involves opening the natural lens and to vaccum out its contents. A bio inert acrylic lens like symfony or silicon lens like crystalens or Trulign is than placed in this natural space. If you want to see far and near in each eye, than PIE procedure may be the better option.

Cataract surgery after Radial Keratotomy

If you have cataracts, special calculations and highly skilled surgery would be required. Accurate measurements of the length of the eye are made using the latest generation of optical biometers like IOL master 700 or Lenstar. Corneal curvature needs to be verified on various devices like Atlas 900 topography, keratometry units. These have to be placed in special formulas to generate the power of the artificial implant to nbe inserted. In special situations the power may need to be recalulated on the operating table using ORange.

At the time of surgery special precautions have to be taken while making incisions to enter the eye. They have to be placed carefully between the preexisting RK cuts. Care has to be taken not to intersect the new openings with previous cuts lest the old wounds open up. If they do they can be sutured.  If no gaps can be found such as in 32 cut Rk, than Dr. Khanna has resoreted to making scleral wounds to enter the eye.

Recent iFDA approved procedures like corneal cross linking help stabilize the fluctuation in cornea and vision after radial keratotomy.

Older procedures like suturing, lasso techniques may be employed in certain special situations.

To find out which procedure is right for you, contact The Khanna Institute today to schedule a free vision consultation. Our friendly staff can answer any questions you may have about Dr. Khanna’s approach to correcting Radial Keratotomy (RK) problems.

We serve patients throughout the Los Angeles area, with offices in Beverly Hills and Westlake Village, California. So call (310) 482 1240 now.

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