24 years post-RK, need advice for presbyopia

[Mark77]

I have had a radial keratotomy in 1985 and now I have presbyopia (need reading glasses). I know that NearVision CK is not recommended. I had 8 radial incisions in one eye and 6 radial incisions in the other and the procedure was done only once and it was a success. One eye is 20/40 and the other is 20/20 now. I know there is a possible problem with unstable corneas because of the RK but this doesn't seem to be a problem. I am looking for someone else who had RK and then subsequently had Monovision to correct for reading and if there were any complications. Thanks in advance.

I am also looking for referrals for surgeons who have experience in treating post-RK patients for presbyopia.

[rkeyes]

Like Mark77, I am having trouble with presbyopia. However, also having trouble with unstable vision during the day, and progressively worsening farsightedness. My correction is now about as bad on the plus side as it was on the minus side before RK, for distance vision. I am more concerned about the vision instability and the worsening farsightedness than the need to wear glasses fulltime again. I feel like my corneas were damaged by the surgery. I had close to 20/20 in both eyes until I was about 45, and also did not need reading glasses. I am now almost 53. (had RK in my early 30's). I've read about corneal collagen crosslinking on this website. It sounds like this might fix the unstable vision during the day and worsening farsightedness. Has anyone had any experience with this?

[Mark77]

I also read about the collagen crosslinking but I don't think it has been approved yet but I think it is a viable option to stabilize and strengthen the corneal and it may correct the astigmatism. So what I did is get injectable riboflavin 10mg/ml and I put one drop in each eye once a day before I go outside in the sun. I also take 400mg of riboflavin orally per day. When I put the drop in the eye the vision seems to improve but it doesn't last. At least maybe it will prevent the myopia from getting worse. Vitamin C, Proline and Lysine also help to stabilize collagen and connective tissue.... I take those also. At least my vision seems to be stable and only the presbyopia is getting a little worse.... I am up to about +175-+200.

I will wait for the collagen crosslinking to be approved and have decided not to do conductive keratoplasty or any laser treatment.

[rkeyes]

Mark77, thanks for your reply. I had an eye exam yesterday. The last one was 3 years ago. My prescription has changed +0.75 in each eye. The doctor said the average is +0.1 per year for post RK, and they're finding out that this is a very common problem with RK patients - A LOT more common then they thought 20 years ago when I had RK. If you're under 45, you may not be "out of the woods" yet. According to the doctor, the crosslinking is undergoing FDA testing, and, if successful by their standards, it will be a minimum of 3 years before it is available. It is already in use in Europe. He didn't say anything about it until I asked. He said he was reluctant to because there have been other procedures that showed promise that didn't make it out of FDA testing. Given the unexpected longterm outcome of RK, I'm going to be a lot more cautious having anything else done to my cornea. At least I'm still correctible to 20/20.

[Mark77]

Corneal Collagen Cross-linking C3R) is already available in Canada.

hxxp://www.yongeeglintonlaser.com/html/keratoconus.html

(replace the xx with tt)

I emailed them to ask about any experience with RK patients. No response yet.

I am already over 50.... and actually at +175 my reading vision is not as bad as my 2 sisters who are 5 years younger and my brother who is one year older. .... and I am a heavy reader.

My health is excellent.... and have always taken antioxidants and I know that has helped me tremendously.

The surgeon who performed my RK was one of the original 4 who went to Russia to learn the technique.... He was at Michigan (Dearborn) Eye Institute. He did not over-correct my vision which I think made a difference. I do have a slight astigmatism in the left eye which I think can be corrected with C3R. It seems to be the least invasive technique.

[rkeyes]

My prescription as of a few days ago:
Sph. Cyl Axis
R +2.25 +0.50 153
L +1.50 +0.25 045

Add Near Add Intermed
R +2.25 Progressive
L +2.25

I started out somewhere between -2.5 and -3 in each eye. My doctor did over correct. I was able to see without glasses until 45. Was close to 20/20 distance until that time, but probably needed reading glasses sooner.

I hope the colligen cross linking turns out to be the answer, but I not real excited about having anything else done to my eyes. At least my vision problems are still correctable to 20/20. One concern I have about crosslinking is that it may affect the clarity of the cornea.