Radial keratotomy (RK) is a refractive surgical procedure that became very popular during the 1980s and remained so through the mid-1990s when the excimer laser was approved by the FDA in November of 1995. RK was used to treat low to moderate near-sightedness (myopia). It was often combined with astigmatic keratotomy to treat astigmatism. In RK, deep radial incisions were made in the cornea using a precision diamond blade. These incisions caused a weakening and out-bowing of the mid-peripheral cornea that in turn caused flattening of the central cornea. This flattening of the cornea reduced the near-sightedness. Although the initial results were excellent, a study done in the 1980s showed a progressive effect of RK over the years. The result was that patients initially did well, but over time developed hyperopia which is opposite to near-sightedness. When we were doing RK in the 1990s, our hope was that newer RK techniques using smaller incisions would eliminate or lessen this progressive effect. Unfortunately, it seems that even these patients have a tendency to “drift” toward far-sightedness over the years. What this means is that if you are over 50 years old and have had RK in the past, you probably need glasses now for both distance and reading.
Many patients who are now far-sighted after RK have asked their ophthalmologist or optometrist if they are candidates for laser vision correction and were told that they were not. The use of the excimer laser for post-RK patients was studied in the early 1990s. At that time the results were not particularly good. However, since that time there have been significant advances in excimer laser technology. Improved technology and treatment protocols and the use of mitomycin C to prevent scarring have combined to make laser vision correction an excellent option for RK patients. While Lasik usually provides a rapid recovery of vision, the creation of a corneal flap in this technique can have complications in some cases. PRK is a safer technique that avoids the potential for problems with a corneal flap. While laser vision correction can give excellent visual results, fluctuations in vision will still occur to some degree in patients who have had RK. These fluctuations are the result of RK weakening the cornea.
If you are now experiencing problems with your vision after having had RK years ago, a comprehensive evaluation would help determine whether laser vision correction is an option for you.
For more information please call 661-259-3937.