TREATMENT OF PRESBYOPIA (READING GLASSES)
Current applications of Conductive Keratoplasty :
Approved indications :
Temporary induction of myopia (-1.00 D to -2.00 D)to improve near vision in the non-dominant eye of presbyopic hyperopes or presbyopic emmetropes by using a hyperopic treatment ranging from 1.00 to 2.25D. US FDA approval was given for this indication in March 2004. Spherical hyperopia + 0.75 D to + 3.25 D
Potential applications :
Enhancing Lasik outcomes
Enhancing pseudophakic (after IOL implant) outcomes
CONDUCTIVE KERATOPLASTY (CK)
Conductive keratoplasty is a thermokeratoplasty technique that uses radio frequency energy to heat and reshape the cornea. Conductive Keratoplasty or CK is "laser less." It involves the controlled intrastromal delivery of radio frequency energy by means of a contact probe tip.
DESCRIPTION OF THE CK EQUIPMENT :
The CK procedure is performed with the ViewPoint CK System. The console is about the size of a VCR and is portable. The CK handpiece & the speculum are connected to the console using colour - coded cables.
SELECTION CRITERIA FOR CONDUCTIVE KERATOPLASTY
- Patient above 45 years of age
- < + 0.75 D for distance in nondominant eye
- < 1.0 D astigmatism
- Good bilateral BCVA
- < 2+ nuclear sclerosis
THE CK PROCEDURE :
CK is a very simple procedure to perform. The entire procedure takes about 3 minutes.
Step 1 : Topical anesthesia (Proparacaine 0.5% drops) is instilled.
Step 2 : The lid speculum (return path for energy) provided with the system is then inserted.
Step 3 : The cornea is marked using the standard CK marker.The Keratoplast tip is inserted into the cornea into these pre - marked optical zone marks.
Step 4 : The Keratoplast tip is inserted into each corneal marking of a chosen optical zone in a
sequential manner & the foot pedal is depressed to deliver the radio frequency energy.
The optical zone to be treated is decided based on the degree of error being corrected.
Step 5 : Satisfactory sphericity is then confirmed
MECHANISM OF CONDUCTIVE KERATOPLASTY
A circle of cylindrical treatment spots applied in the mid-peripheral cornea results in a band of tightening and the subsequent central corneal steepening and peripheral flattening. The effect of Conductive Keratoplasty lasts for 3 - 5 years and reduces your dependence on reading glasses. A repeat treatment can be done after 3 - 5 years if presbyopia progresses.
CK - Optical Zones
View-Point CK System
CK - marker
POST-CK INCREASED CORNEAL CURVATURE
1.What is ReLEx?
Refractive Lenticule extraction (ReLEx) is a novel refractive surgery and the most advanced LASIK Procedure in the world. This All-femto laser vision correction is the technique of the future.
2.What is SMILE?
Small incision Lenticule Extraction ( SMILE ) is minimally invasive and innovative procedure. The refractive lenticule cut is performed using a state of the art Femtosecond laser and the lenticule is extracted through a small corneal incision
3.How safe is the procedure?
This effective and predictable technique also provides a safety and stability that cannot be matched with traditional LASIK. ReLEx SMILE is free from flap related complications possible with other forms of LASIK. Corneal infections are rarely seen after the procedure.
The cornea is Biomechanically more stable after ReLEx SMILE as the cut made on the cornea is 80% smaller than the flap cut made during conventional LASIK, minimizing the chances of late corneal thinning and ectasia
4.How different is it from LASIK?
Conventional LASIK is a two step procedure. 1st step is creation of a corneal flap using either a mechanical microkeratome or a Femtosecond Laser. 2nd step is corneal ablation using an excimer laser to reshape the cornea by removing and ultra thin layer of the cornea to correct the refractive errors.
Small Incision Lenticule Extraction (SMILE) technique is a key hole procedure, it eliminates the need to cut a corneal flap. A Femtosecond laser is used to dissect a lenticule in the corneal stroma without making a flap. The dissected lenticule is than removed from the cornea through small incision which is 2-4 mm in size. This procedure is the safest and arguably the best LASIK technique today
5.What are the advantages on ReLEx SMILE?
The main advantage of this technique is the short recovery time. Dryness induced by SMILE procedure is significantly less compared to other forms of LASIK. The rare possibility of flap related complications seen with other forms of LASIK is not found in patients undergoing SMILE. Finally, because there is no flap being dissected in ReLEx SMILE, there is no chance of traumatic flap displacement, making this procedure the safest LASIK procedure for patients engaged in contact sports.
6.How much time does the procedure take?
15-20 minutes for both the eyes.
7. Will my vision be normal immediately after surgery
Your vision will start improving in a few hours and will be near normal after the first 24 hrs. However, the vision may be slightly hazy in some patients and gets back to normal over the next 2-4 weeks
8.What about Dryness?
The number of corneal nerves severed during the procedure is far lower than that if conventional LASIK. The resulting dry eye symptoms are significantly lesser in patients undergoing ReLEx SMILE.
9.Will I have glare after the procedure?
Most patients experience night time glare after the surgery for the first few weeks. Rarely, glare and haloes may persist for a much longer period.
10.Can all refractive errors be corrected with ReLEx SMILE?
ReLEx SMILE can correct Myopia and Astigmatism. Hypermetropia ( Plus Power) and Presbyopia can not be corrected with this procedure. These patients have to be treated with conventional LASIK
11.Am I a suitable candidate?
Most of the patients suitable for conventional LASIK can also be treated with ReLEx SMILE. You have to consult your ophthalmologist for a detailed examination.
12.How soon can I get back to my normal routine after ReLEx SMILE
You can resume your normal routine in 2-3 days. Now we offer our patients unmatched comfort, Faster recovery and accurate results with corneal refractive surgery (LASIK) and corneal Transplantation.