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...

Fluorophotometry to evaluate the corneal epithelium in eyes undergoing contact lens corneal reshaping to correct myopia.

Related Articles

Fluorophotometry to evaluate the corneal epithelium in eyes undergoing contact lens corneal reshaping to correct myopia.

J Refract Surg. 2009 Apr;25(4):366-70

Authors: Savitsky DZ, Fan VC, Yildiz EH, Du TT, Asbell PA

PURPOSE: To determine whether use of Corneal Refractive Therapy (CRT, Paragon Vision Sciences) lenses have an adverse effect on the health of corneal epithelium by monitoring epithelial permeability by fluorophotometry. METHODS: Eight patients with healthy eyes and whose refractive error was between -0.50 and -4.00 diopters (D) sphere and up to -1.75 D of astigmatism were enrolled. On the day of the fitting, two baseline fluorometric scans of the right eye were taken using the Ocumetrics Fluorotron Master. After 15 minutes, another two scans were taken of the right eye. The same fluorophotometry technique was repeated on day 1, 1 week, 1 month, and 3 months after the patient began overnight wear of the lenses. Patients' baseline corneal fluorescein levels and peak corneal fluorescence values after rinsing were compared to initial pre-fitting values to determine changes in corneal epithelial permeability. RESULTS: After patients used orthokeratology, uncorrected visual acuity was 20/20 or better in 9/16 eyes and 100% had achieved 20/40 or better by day 7. No adverse events were seen in patients utilizing orthokeratology, and eye examinations for these patients continued to be within normal limits. After nightly use of orthokeratology for 1 month, baseline fluorescence of the cornea (15.64 +/- 2.29 ng/mL vs 17.31 +/-5.43 ng/mL, P = .80) remained stable, and the post-15 minute scan peak corneal fluorescence values did not show significant changes from the pre-fitting (51.46 +/- 17.28 ng/mL) after use of orthokeratology (63.80 +/- 41.25 ng/mL) (P = .78). CONCLUSIONS: Reshaping of the cornea through the use of orthokeratology does not have adverse effects on corneal epithelium as evaluated by changes in corneal epithelial permeability.

PMID: 19431927 [PubMed - in process]