CLAPIKS

Contact Lens Assisted Pharmacologically Induced Kerato Steepening (CLAPIKS) is a process to correct residual hyperopia, (farsighted, longsighted) myopia, (nearsighted, shortsighted) and possibly astigmatism after conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, RK, or similar laser assisted refractive surgery with the use of extended wear contact lenses and the nonsteroidal anti-inflammatory drug (NSAID) Acular (ketorolac tromethamine, Allergan). This is an off label use of the eye drops.

Surgeons have successfully treated hyperopic overcorrection following Lasik, LASEK, PRK, Epi-Lasik, and RK, by molding the cornea with a tight fitting contact lens and Acular. CLAPIKS has shown to be effective on patients who have been overcorrected by 0.50 to 3.00 diopters of hyperopia following refractive surgery. This is a new technique and doctors are still discovering its application and limitations.

There is some concern about NSAID's side effects of corneal melting. Allergan has not reported melting in people with normal corneas. CLAPIKS has initially been used only with Acular, but other NSAIDs may be appropriate. Patients with collagen diseases or other corneal melt problems should not be treated with this technique.

The process usually takes several weeks of continued contact lens fitting and use of the drug before significant refractive change is achieved. Click CLAPIKS for a copy of the CLAPIKS protocol, suitable for an eye doctor. To view this file, you must have Acrobat Reader.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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Current Corneal Steepening Medical Journal News...

Relationship between corneal topographical changes and subjective myopic reduction in overnight orthokeratology: a retrospective study.

Related Articles

Relationship between corneal topographical changes and subjective myopic reduction in overnight orthokeratology: a retrospective study.

Clin Exp Optom. 2010 Jul 1;93(4):237-42

Authors: Chan B, Cho P, Mountford J

Background: To investigate the relationship between the change in the manifest refractive error (DeltaM), the change in apical corneal power (DeltaACP) and initial corneal asphericity (Q) in overnight orthokeratology (ortho-K). Methods: One hundred and twenty-eight clinical records of children undergoing ortho-K from a university optometry clinic were reviewed. The refractive and topographical data at baseline and at two-week visit of 58 patients who fulfilled the inclusion criteria were retrieved and analysed. Results: Significant differences (p < 0.001) between the change in manifest refractive error and changes in the apical corneal power or the maximum change in corneal power (DeltaMCP) within the treatment zone were found. Linear regression analysis was used to describe the change in manifest refractive error and the change in apical corneal power, and the change in manifest refractive error and the maximum change in corneal power, with the equations: DeltaM = 0.91DeltaACP + 0.57 (r = 0.78, p < 0.001) and DeltaM = 0.93DeltaMCP + 0.01 (r = 0.79, p < 0.001) respectively. On average, the change in apical corneal power underestimated the change in manifest refractive error by 0.34 +/- 0.57 D; whereas on average, the maximum change in corneal power overestimated the change in manifest refractive error by 0.23 +/- 0.57 D (paired-t-tests, p < 0.001). A low but significant correlation between initial corneal asphericity and the change in manifest refractive error (Spearman r = -0.33, p = 0.01) was observed. Conclusions: The change in apical corneal power underestimates the change in manifest refractive error in ortho-K, whereas the maximum change in corneal power overestimates this parameter. Compared with retinoscopy and autorefraction, the change in apical corneal power is still useful for estimation of the change in manifest refractive error. Although the maximum change in corneal power appears to give a closer estimation of the change in manifest refractive error than the change in apical corneal power, there is no advantage in the use of maximum corneal power (manually located) instead of apical corneal power (a default given by the topographer) to estimate the change in manifest refractive error, as there is no significant difference in the estimations by either parameter. Initial corneal asphericity measured by the Medmont E300 corneal topographer has limited usage in predicting the change in manifest refractive error in overnight ortho-K.

PMID: 20579079 [PubMed - in process]