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...

Histomorphometric Profile of the Corneal Response to Short-term Reverse-geometry Orthokeratology Lens Wear in Primate Corneas: A Pilot Study.

Related Articles

Histomorphometric Profile of the Corneal Response to Short-term Reverse-geometry Orthokeratology Lens Wear in Primate Corneas: A Pilot Study.

Cornea. 2008 May;27(4):461-470

Authors: Cheah PS, Norhani M, Bariah MA, Myint M, Lye MS, Azian AL

PURPOSE:: To investigate the histological changes in primate cornea induced by short-term overnight orthokeratology (OK). METHODS:: Nine young adult primates were used. One animal served as negative control. The remaining 8 animals wore reverse-geometry OK lenses for periods of 4, 8, 16, and 24 hours on 1 eye with the other eye as control. Central and midperipheral corneal thickness, as well as ultrastructural changes in corneal epithelium, stroma and endothelium in response to OK lenses, were evaluated. RESULTS:: OK significantly reduced the thickness of the central cornea in all treatment groups. The central corneal thinning was both stromal and epithelial in origin. Substantial midperipheral corneal thickening was seen in 16-hour and 24-hour lens-wear groups and this effect was both stromal and epithelial in origin as well. Histology evidence indicated the primary epithelial response in the central cornea was compression of cells that resulted in wing cells becoming shorter and basal cells being squatted rather than lost or migration of cell layers. These pronounced cell shape changes occurred without compromising the structural integrity of the desmosomes. The thickened corneal epithelium has normal cell layers. The squamous cells have larger surface sizes and are composed of oval instead of flattened nuclei. This implied delayed surface cell exfoliation at the thickened midperipheral epithelium. Physical presence of OK lens over the cornea did not influence the microstructures of microvilli and microplicae, endothelium, and collagen distribution. CONCLUSIONS:: The primate cornea, particularly the corneal epithelium, responds rapidly to the application of reverse-geometry OK lenses with significant epithelial cell shape alterations with short-term OK lens wear. This finding suggests that the corneal epithelium is moldable in response to the physical forces generated by the OK lenses.

PMID: 18434851 [PubMed - as supplied by publisher]