Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.


Postby WJMENKE » Thu Sep 14, 2006 9:59 pm

I had RK on both eyes in 1991 and had great vision up until last year. My left eye has become fairly blury while my right while not 20/20 anymore is still very functional.

If I was to concider correction would I be better doing RK again or use PRK as an alternative??

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Postby LasikExpert » Thu Sep 14, 2006 11:44 pm

You probably can't find five doctors in the western world who would do Radial Keratotomy (RK) on you. RK has been replaced with laser assisted procedures like Lasik and PRK, which are much more predictable and safer by medical standards.

Before you decide which surgery to have, you may want to decide if surgery is what is needed. If you are at or past age 40, you are probably suffering from presbyopia. This is when the natural lens inside the eye is less able to change focus to be able to see objects near and reading glasses or bifocals are required.

If your vision is slightly myopic (nearsighted, shortsighted) then you may not want to have it corrected. Being a little myopic can help with presbyopia. Most people use reading glasses or bifocals to deal with presbyopia, but staying slightly myopic or monovision are alternatives.

If you are becoming hyperopic (farsighted, longsighted) then it is a whole different situation. Many post-RK patients are experiencing a hyperopic shift and/or vision fluctuations. The combination of hyperopia and presbyopia tends to provide poor vision at all distances.

The concern will be the stability of your cornea. If you are just experiencing normal changes in vision, then refractive surgery may be appropriate. You will want to discuss details with your doctor, but Lasik carries a greater risk of weakening a post-RK cornea and when the Lasik flap is made the cornea can split at the RK incisions like so many pieces of pizza. PRK may be a better alternative, if any surgery is appropriate.

If your corneas are stable, your first line of defense for the described vision changes should probably be glasses or soft contact lenses. If your cornea is unstable, then I recommend you consider rigid gas permeable (RGP) contact lenses. Hard contacts have come a long way in 15 years. They are much healthier for the eyes and more comfortable to wear. The combined advantage of vision correction and support for your cornea can be what you need.

It is also possible that your vision changes are caused by the early stages of cataracts. Age related cataracts are when the natural lens of the eye becomes cloudy.

You need a comprehensive examination by a competent doctor who has significant practical experience in treating post-RK patients.
Glenn Hagele
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