Treating Radial Keratotomy Using Scleral Lenses

Radial keratotomy (RK) was once one of the most popular refractive surgery techniques. However, with advancements in laser-based procedures such as LASIK (Laser-Assisted In Situ Keratomileusis) and PRK (Photorefractive Keratectomy), it’s been shown that there were serious issues with this type of ocular surgical approach. In turn, there are many people who still struggle with the consequences of radial keratotomy. Scleral lenses have been shown to ease the issues that have manifested as a result of radial keratotomy and provide countless individuals with the clear vision that they need and deserve.

What is Radial Keratotomy?

Radial keratotomy (RK) is a surgical procedure that was made popular in the 1980s and 1990s. This procedure was commonly used to correct myopia by reshaping the cornea. The cornea is the clear front part of the eye that helps focus light onto the retina. Despite its popularity, radial keratotomy is no longer performed due the numerous complications that have developed as a result of this surgery.

During a radial keratotomy procedure, the surgeon makes a series of radial incisions on the cornea using a diamond knife or a laser. These incisions are made in a spoke-like pattern, starting from the center of the cornea and extending toward the periphery. By creating these incisions, the cornea is flattened, which reduces its curvature and allows light to focus properly on the retina.

Why are Scleral Lenses the Best Option Following Radial Keratotomy?

Scleral lenses are often considered a good option following radial keratotomy (RK) for several reasons:

1. Corneal Shape Correction: Radial keratotomy can lead to corneal irregularities, including an uneven shape or induced astigmatism. Scleral lenses, which vault over the entire cornea and rest on the sclera (white part of the eye), create a smooth and regular optical surface. This helps to mask corneal irregularities and provide clearer, sharper vision compared to other contact lens options.
2. Stability and Comfort: Scleral lenses have a larger diameter than traditional contact lenses, providing greater stability on the eye. The lens rests on the sclera, which is less sensitive than the cornea, resulting in improved comfort for many individuals. The liquid-filled reservoir between the lens and the cornea helps to maintain a consistent environment and lubrication, reducing dryness and discomfort.
3. Reduced Friction and Improved Corneal Health: Scleral lenses do not make direct contact with the cornea but instead rest on the sclera. This minimizes friction and rubbing on the corneal surface, reducing the risk of corneal abrasions or irritation. The fluid-filled space between the lens and the cornea also promotes improved oxygen and nutrient flow, supporting corneal health.
4. Customization: Scleral lenses can be custom-designed and tailored to the specific needs and irregularities resulting from RK. They can accommodate a wide range of corneal shapes and sizes, including highly irregular corneas. The fitting process involves taking precise measurements and creating a lens that provides optimal vision and comfort for each individual.
5. Vision Quality: Due to their larger size and unique design, scleral lenses provide more stable vision compared to other contact lens options. They minimize the impact of corneal irregularities, including induced astigmatism, resulting in improved visual acuity and reduced glare or halos.

It’s important to note that while scleral lenses offer many advantages, they may not be suitable for everyone. The fitting process requires expertise and specialized equipment, so it’s essential to consult with an eye care practitioner experienced in fitting post-RK scleral lenses. They will assess your individual needs and determine the best course of action for your vision correction.

What are the Complications from Radial Keratotomy That Scleral Lenses Can Help Correct?

Scleral lenses can be beneficial in addressing several complications that may arise following radial keratotomy (RK). Here are some complications where scleral lenses can provide corrective measures:

1. Irregular Corneal Shape: Radial keratotomy can sometimes result in irregular corneal shape, leading to distorted or blurred vision. Scleral lenses, with their larger diameter and unique design, vault over the cornea and rest on the sclera (white part of the eye). This creates a smooth and regular optical surface, masking corneal irregularities and providing clearer, sharper vision.
2. Induced Astigmatism: RK can induce astigmatism, causing visual disturbances. Scleral lenses are specially designed to correct astigmatism and can provide precise astigmatism correction due to their customized fitting. By providing a uniform and stable optical surface, scleral lenses can mitigate the effects of induced astigmatism and improve visual acuity.
3. Dry Eyes: Dry eye symptoms can occur after RK, and scleral lenses can help alleviate associated discomfort. These lenses create a reservoir of fluid between the lens and the cornea, which helps to keep the ocular surface lubricated and protected. This moisture retention can alleviate dryness, reduce irritation, and enhance comfort for individuals experiencing dry eye symptoms.
4. Corneal Irregularities: If the cornea develops irregularities post-RK, such as irregular astigmatism or scarring, scleral lenses can provide a smooth and regular optical surface. The lens vaults over the cornea, bypassing the irregularities and allowing light to enter the eye in a more controlled manner. This results in improved vision quality and reduced visual disturbances.

By addressing these complications, scleral lenses offer a customized and effective solution for individuals who have undergone radial keratotomy. It is crucial to consult with our team in fitting scleral lenses to determine the most suitable lens design and ensure proper fitting for optimal visual outcomes and corneal health.