CK^SM (Conductive Keratoplasty^SM)

About Conductive Keratoplasty and Near Vision CK

Presbyopia and Baby Boomers

Presbyopia, Greek for “aging eye,” is a progressive condition that causes near vision to fade with age. Presbyopia is the most prevalent eye condition in America. It affects most people by the age of 40 and everyone by the age of 50. An estimated 90 million Americans (baby boomers) either have presbyopia or will develop the condition in the next 10 years.

Symptoms of presbyopia include difficulty with all forms of near vision, such as reading, ordering from a menu, checking a price tag, dialing a cell phone, or even doing hobby work. People affected by presbyopia often own multiple pairs of reading glasses and must rely on them for even the most mundane activities.

Farsightedness occurs when the patient’s cornea is too flat or the eye is slightly small in front to back diameter. Presbyopia is the gradual loss of near vision due to loss of flexibility of the crystalline lens of the eye, which occurs in all of us by the age of 50.

Conductive Keratoplasty (CK)

CK does not utilize a laser or cut the cornea. CK is performed using a probe thinner than a human hair, that releases radiofrequency energy. Applied to the cornea in a circular pattern, the radio waves shrink small areas of collagen to create a constrictive band (like the tightening of a belt) that increases the curvature of the cornea, bringing near vision back into focus. Near Vision CK refers to the CK procedure for presbyopia that is similar to CK for farsightedness.

NearVision CK is used for the temporary improvement of near vision in emmetropic presbyopes (those who require only reading glasses).CK is also performed for hyperopic presbyopes (those who require reading and distance glasses) but may not be as effective as LASIK or PRK for these individuals.

NearVision CK is typically performed on just one eye, improving near vision without significantly compromising the patient’s binocular distance vision. The distance vision will usually diminish by 2-3 lines on the eye chart (called Snellen lines) due to induced nearsightedness. Usually, the non-dominant eye is chosen for near vision.

CK is performed as an outpatient procedure, using only a drop of topical anesthetic. You will want to take the day off of work, and take it easy the rest of the day, but there are no significant restrictions on your normal activities.

Who is a candidate for CK or Near CK?

• You have had good distance vision without glasses or contact lenses throughout your life. This means that you do not have significant nearsightedness, farsightedness or astigmatism.
• Need reading glasses after age 45 or beyond
• Difficulty reading menus, cell phones, labels, recipes
• Eye fatigue when reading in poor lighting or at the end of the day
• Constantly repositions reading material in an attempt to find the right focus

How does CK work?

CK makes the cornea steeper and increases its focusing power
CK uses a pen-shaped instrument with a cool tip as thin as a human hair.

After application of a topical anesthetic (eye drops), radio frequency (RF) energy is applied in a circular pattern. Each application is for less than a second. This pattern is along the periphery of the cornea and minimizes interference with your line of sight. For Near Vision CK, 16 applications are usually applied.

Probe delivering radio frequency energy		There will be eight to 24 treatment points

What to expect the day of the procedure?

The procedure is done at the Phillips Eye Institute; you'll be there about two hours on the treatment day including the check in an hour before. The CK procedure itself takes approximately ten minutes. You will feel some pressure on the eye and eyelids during the surgery but the procedure does not hurt. Once finished, you don't have to wear a patch and can usually return to work the next day. In some patients, a soft contact lens is usually placed at the time of the procedure. The contact lens is removed in one to three days. Vision continues to improve during the first several weeks. There may be some irritation, tearing and mild pain in the first day or two after surgery. Eye drops are given to reduce the pain and discomfort. On occasion, a pain pill is required, but this is unusual.

Risks:

The fact that there is no removal of corneal tissue (as in LASIK or PRK) and no treatment in the center of the visual axis leads to the safety of CK.

As with any surgical procedure, there are risks. The most common risk is the induction of astigmatism. These may result in some loss of best corrected vision (sharpness) in the treated eye, both in the distance and at near. This loss of vision usually resolves but may be permanent. Fortunately, this occurs very infrequently. In general, CK is safer than LASIK and PRK, which are both very safe procedures

Is Conductive Keratoplasty- (CK) permanent?

Unlike LASIK or PRK, it is not known how long the effects of CK will last. It is thought that there will be some loss of effect each year and that the effect will last for about 5 years. Unlike myopia, which is stable in adult life, farsightedness progresses as we age and it is hard to compare the effect of progression with regression of the surgical effect.

Can CK be repeated?

Yes. Additional applications of RF energy can be applied to enhance or restore the effect of the procedure. This can only be done one time after the original procedure. Within the first year after surgery, this is done without fee. After one year, there is a reduced fee for the enhancement procedure.

Is CK reversible?

As with most vision correction procedures, CK is not reversible. Once the procedure has been performed, it is not possible to “remove" the effects of the procedure. This is an important factor that anyone thinking about surgery should carefully consider. To make sure CK is right for you, make sure you discuss your vision needs with Dr. Sher.

Will my vision improve immediately after surgery?

Patients usually notice an immediate improvement in their vision after the CK procedure. However, it normally takes several weeks for the eyes to reach the final level of correction.

Will my vision fluctuate after the procedure is performed?

Most patients will experience mild fluctuation in their vision after surgery, but many will never notice it. Any fluctuation will usually subside within a few weeks. Patients who undergo vision procedures for near vision usually require a longer stabilization period than those treated for distance vision.

Can CK be performed after prior PRK or LASIK or cataract surgery?

Sometimes, preliminary and ongoing studies are being performed on the use of this in eyes with prior refractive procedures. However, CK after prior corneal surgery such as PRK or LASIK is not as predictable.

How can I obtain additional information?

The website of Refractec, the manufacturer and developer of conductive keratoplasty equipment, has a large amount of information:

http://www.refractec.com

The US Food and Drug Administration website has a large amount of clinical trial data from the original FDA approval of CK for farsightedness.

http://www.fda.gov/cdrh/pdf/p010018.html

The first non-laser procedure for Near Vision is now being done! Find out if Conductive Keratoplasty^SM (CK^SM) can help you.

View video clip about Conductive Keratoplasty (CK)!
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