Zembla Documentary on Lasik, Pain, and Suicidality

This Lasik documentary was created by investigative journalists in Holland. The language is mostly Dutch, with English subtitles. The documentary focuses on corneal neuropathic path after Lasik and the suicidality it creates. Dutch physician Dr. Michael Brouwer and other Lasik sufferers in Holland are interviewed, as is Dr. Edward Boshnick in the United States (see EyeFreedom.com). The investigators ask: Is the experience of pain after Lasik really uncommon? What are the consequences when it occurs? Also interviewed are Dr. David Barsook and Dr. Morris Waxler. Dr. Barsook is Director of the Pain and Imaging Neuroscience (P.A.I.N.) Group at Boston Children’s Hospital, MGH ,and McLean Hospital at Harvard University. Dr. Barsook maintains that corneal pain after Lasik follows an established model of neuropathic pain. Dr. Morris Waxler is the FDA's former chief research scientist on Lasik. Dr. Waxler maintains at his website HelpStopLasik.com that "The FDA does not want to admit that millions of people have now had a surgery that never should have been approved by its own rules. The FDA is now engaged in covering-up a scandal and an epidemic, and its own corrupt practices. This should be exposed, and LASIK should end." He revisits these conclusions in the video.

RK

GVR Scleral Lens and RK

Radial Keratotomy (RK) was the first refractive surgical procedure introduced into the United States. Millions of patients around the world underwent this needless and harmful procedure in the 1980's and 1990's. Over two million procedures were done in the United States and Canada alone. In addition, over a million LASIK procedures were later done to these same patients in an attempt to undo the damage done by the initial RK surgeries. The end result of these multiple refractive surgical procedures was millions of permanently damaged eyes requiring either corneal transplant surgery or the use of specialty contact or scleral lenses.

Radial Keratotomy involved the making of small deep slices into the cornea (the front surface of the eye) in an attempt to reduce nearsightedness (myopia) and astigmatism. The long term results of RK were complications that were so horrific that many of these patients were unable to function visually either with eyeglasses or contact lenses. In addition to the reduced vision, most of these hurt patients experienced significant ocular discomfort and pain. Many complications occurred years after the surgeries were done. These complications include:

  • 1. Loss of best corrected visual acuity.
  • 2. Double or triple vision.
  • 3. Irregular corneal curvatures.
  • 4. Unstable or fluctuating vision.
  • 5. Severe dry eye.
  • 6. Halos, glare and reduced indoor and night vision.
  • 7. Permanently open incisions.
  • 8. Recurrent ocular infections and inflammation.
  • 9 Severe depression and in some cases thoughts of suicide.

Over the years our specialty practice has treated thousands of RK patients who also underwent additional RK procedures followed by one or more LASIK procedures. In every instance, the additional surgical procedures only made matters worse. Many of these patients (less than 5%) eventually needed to undergo corneal transplant surgery.

In recent years advancements in scleral lens technology have allowed the great majority of this hurt patient population to see clearly and comfortably once again. Virtually every hurt post-RK/ post-LASIK patient who were fit with the GVR Scleral lens experienced a dramatic improvement in their visual acuity and ocular comfort.

The GVR Scleral lens is unique in that this lens vaults over the compromised cornea and rests on the white portion of the eye known as the sclera. Sterile unpreserved saline solution fills the space between the back surface of the lens and the front surface of the cornea. Comfort and vision are almost always excellent. In addition, the dryness (scratchy and itchy) issues that so many post-refractive surgical patients experience are for the most part gone. In other words, the GVR Scleral lens has a therapeutic effect of the damaged eye. It is not unusual for a post-RK patient to comment to us after having received their GVR Scleral lenses that they now have their life back.

An Example: This eye underwent R-K surgery in 1988. LASIK was performed in 2002. Shortly thereafter, post-LASIK ectasia developed. The R-K incisions are still open. A dye was instilled onto the corneal surface. You can tell that the incisions are still open because the dye can be seen within the incisions. The green-yellow circular line going around the periphery of the cornea is the LASIK flap. We fit this eye with a GVR Scleral lens in 2007 which has provided this eye with clear stable vision ever since.

20/200 RK Eye

This is a photo of a scleral lens over an eye that underwent 3 separate Radial Keratotomy (RK) surgeries. Look carefully and you will see many RK incisions or "slices" going every which way on this cornea. Just know that there was no science behind this horrible surgery. The medical specialty that brought you RK is the same medical specialty advertising LASIK, "Smile" and all of the other refractive surgeries that have the potential to damage your eyes irreversibly. The vision in this eye could not be corrected with eyeglasses or conventional contact lenses. With best spectacle correction the vision in this eye is less than 20/200. With a scleral lens this patient can see clearly (20/30) and comfortably once again. One more piece of information: there is no surgical procedure (LASIK, IOL replacement surgery etc.) that will restore the vision that was lost due to the original RK surgery.

RK, infections, inflammations, glaucoma

About 30 years ago this eye underwent Radial Keratotomy (RK) surgery. This eye also has a history of infections and inflammations which were treated off and on for years with steroid eye drops. About 15 years after the RK surgery, this eye was diagnosed with glaucoma which could not be controlled well with medications. Several years ago in an effort to keep the intraocular pressure under control a glaucoma shunt was surgically implanted into this eye. As the years went by this eye became increasingly far sighted and astigmatic with unstable vision. This eye was recently fit with a scleral lens which is providing this patient with clear and stable vision. In the photo below, look carefully at 1:00 O'Clock and you can see the glaucoma shunt next to the edge of the scleral lens. The 2nd image was taken with OCT technology. In this image you can see the scleral lens vaulting over the cornea. Again, look carefully at the extreme right portion of this image and you can see an oval structure. This oval structure is a cross section of the glaucoma shunt.

Selection of RK Eyes

Among the symptoms almost all of the post-RK patients have include some if not all of the following: fluctuating vision, dry eyes, ocular pain, poor night vision, inability to tolerate contact lenses, multiple pairs of eyeglasses to name just a few. There is no surgical procedure or medication that will undo the corneal damage created by this harmful surgery. There is only one technology that will allow a patient suffering loss of vision and ocular comfort due to RK surgery see clearly and comfortably once again. That is a well fit gas permeable scleral lens. There is no soft lens or hybrid lens that will do this as well as a scleral lens. There are a number of reasons why this is so which I can explain another time. The photos below are the eyes of different eyes that underwent RK surgery. Almost all of these corneas still have open incisions after all these years. All of the eyes in the photos below are now successfully wearing scleral lenses. Again, there are a number of reasons why a scleral lens will allow a patient with post-RK corneas to see clearly and comfortably again while soft, hybrid and conventional soft lenses cannot do this.

RK in 1990, 2 on Right Eye, 3 on Left eye

The 2 photos below (which were stained with a special dye) are the right and left corneas of a patient who underwent Radial Keratotomy (RK) surgery in 1990. This patient had 2 separate RK surgeries on her right eye and 3 separate RK surgeries on her left eye. For 10 years following her surgeries she was able to see relatively well and perform her job. She is a physician who was forced to stop working about 15 years ago due to poor vision. Note the brightly colored radial cuts on both eyes. These cuts are lit up because they are still open after all these years. These eyes are also at a risk for infection due to these open cuts. Both corneas are so distorted that eyeglasses and conventional contact lenses are not able to provide this patient with functional vision. The last image seen below is a 3-D computer enhanced image of the front surface of this patient's left cornea. Note how flat and irregular the ocular surface is. Both of this patient's eyes were fit with scleral lenses which are providing clear stable vision to this patient once again. The purpose of my posting these images is to make a point: There was no science behind this surgery. The FDA was not involved in the development or marketing of Radial Keratotomy. When RK surgery came about there was no information about the long term complications of RK surgery. Patients interested in the newer refractive surgeries need to know that there are many "unknowns" and "unknowables" when it comes to all elective eye surgeries.

ALK Disaster

The 4 images below are of the same eye that underwent a procedure known as "Automated Lamellar Keratoplasty" or simply "ALK". To the best of my knowledge, ALK is not done any longer due to the many complications associated with it. This procedure used a microkeratome (a small slicing machine) to alter the shape of the cornea. This eye was very farsighted (hyperopia) before undergoing ALK. In an effort to eliminate the hyperopia, a condition known as corneal ectasia was created. What resulted was a very steep distorted dry cornea that left this patient with 20/400 vision in this eye which could not be corrected with eyeglasses or contact lenses. In the first photo look carefully at the pupil around 4:00. Note the corneal haze. This is a result of this surgery. The 2nd photo shows a more magnified view of the corneal haze. The third photo was taken through a biomicroscope using a special dye and filter to highlight the area of the cornea that was surgically altered. Note the round outlined shape in the center of the photo. This area of the cornea is 6 mm in diameter and is extremely distorted and steep. The dark areas in the center are areas of the cornea devoid of moisture. The last image was taken with a technology known as "optical coherence tomography" or simply "OCT". In this image the thick curved grey structure is the cornea. The 2 lines above the cornea represent the front and back surfaces of a scleral lens. The curved pointed outline in the center of the cornea is where the cornea was surgically altered. There is no surgical procedure that will undo the damage done to this eye by this surgery. The only technology that will allow an eye like this to function visually again is a well designed and fit scleral lens. This patient now has 20/20 undistorted vision with this eye with the scleral lens.

Five eyes with RK or RK then Lasik

The 4 photos below are of 5 different eyes that underwent either RK eye surgery or both RK and then LASIK surgery. The uncorrected vision in these eyes is extremely poor. In the first 3 photos you can see blood vessels that have grown onto the corneal surface, where blood vessels do not belong. The last 2 photos were taken using a special dye to better highlight the corneal defects. In these 2 photos note the green tinted ring going around the corneal periphery. This is the LASIK flap. The green lines going from the outer cornea inward are the open RK cuts. Still open 30+ years later. All of these eyes were fit with scleral lenses. Many corneal specialists will suggest additional surgeries to address the many complications associated with LASIK and other refractive surgeries. My feeling is to avoid all invasive procedures. Scleral lenses, when properly fit, can change the life for the better of a patient with severe loss of vision and ocular comfort.

Blood Vessel Growth over RK incision

This is a photo of an eye that underwent RK surgery in the 1980's. Several years ago one of the RK incisions in the superior portion of this cornea ruptured causing a perforation of the cornea. The event took place during the cataract surgery. Suturing was done to close this wound. In this photo, you can see the scarring, inflammatory response and blood vessel growth over this RK incision. The point of my posting this photo and ocular history is to make sure that the surgeon who does your cataract surgery has a great deal of experience in operating on this type of eye. This eye was fit with a scleral lens which is allowing this patient to see clearly with this eye once again.

Keratomileusis by Barraquer, Followed by RK

These 2 photos were taken of the same right cornea but with different optical systems. In the early 1970's this eye underwent a refractive surgical procedure known as "Keratomileusis". This refractive surgery was the "grandfather" of all refractive surgeries and was developed by Dr. Jose Barraquer in the 1960's. Keratomileusis is a surgical procedure in which a slice of the patient's cornea is removed, frozen and reshaped on a lathe and then sutured back on the remaining cornea to correct the refractive error of the eye. Dr. Barraquer was the only doctor in the world to do this procedure and when he passed away many years ago, this surgery ceased to be done. Note the circular outline going around the inner portion of the cornea. This represents the portion of the cornea that was removed, reshaped and sutured back onto the underlying corneal tissue. About 15 years later, this same eye underwent Radial Keratotomy (RK) surgery. Note the 8 horizontal and vertical incisions extending from the periphery of the cornea onto the central cornea. Needless to say, the vision in this eye has been severely reduced for over 40 years. This eye was fit with a scleral lens which is allowing this patient to see clearly and comfortably once again after all these years.

Eyes Blinded by RK, Very irregular and dry corneas

These eyes were blinded by RK (Radial Keratotomy) refractive eye surgeries. The corneal surfaces of these eyes are extremely irregular and dry. The only technology that will restore quality vision and comfort to these patients is a well fit scleral lens. What is true for a disfigured RK cornea holds true for a cornea damaged by LASIK eye surgery.

ALK on Hyperopic Cornea

The 3 images below are of the same eye. This eye underwent a refractive surgical procedure known as Automated Lamellar Keratoplasty or ALK. This procedure was abandoned about 15 years ago and as far as I know is not being done any longer. This eye was about +4.00 of hyperopia before the surgery. In order the improve this patient's distance vision this surgery created a cornea that looked like a keratoconic cornea or a cornea with post-LASIK ectasia. It was thought that by doing this the light rays would focus directly onto the retina without the need for spectacles. This did not happen. This surgery is done in a similar manner to LASIK except that the treatment zone is small and in the central area of the cornea. In the first photo, note the grey rings around the periphery of the pupil. This is the edge of treatment zone. The 2nd photo was taken after a special dye was instilled onto the ocular surface. In this photo you can see the small elevated treatment zone. The last image was taken with a technology known as "optical coherence tomography" or "OCT". This is a cross sectional image of this patient's cornea. Note the cuts created by the laser. After this patient underwent this needless, harmful surgery, the best corrected visual acuity in this eye was less than 20/200. He is now wearing a scleral lens on this eye which is providing him with 20/30 corrected vision without distortions.

RK - Do NOT try more Surgeries

This post is directed those who've lost quality vision due to Radial Keratotomy (RK) surgery. Below, are photos of different eyes that underwent RK surgery and later on went on to lose quality vision and ocular comfort. All of the patients whose eye photos you see here are now wearing scleral lenses. I strongly urge members of this group who have lost vision due to RK surgery to find a doctor experienced with scleral lens technology. In the photos posted below different dyes were used to highlight the corneal defects created by RK surgery. One word of caution: There are a number of corneal surgeons who are promoting additional surgeries to correct the problems created by RK surgery. There is no invasive procedure that will undo the damage the RK surgery created. Additional surgeries will increase the risk to further loss of vision and comfort.

Wide RK Incisions

Note how wide these incisions are and how far they extend out to the corneal periphery. The 2nd photo is of a cornea with a transplant. When a corneal transplant is done, only the center 6mm to 8mm of the central cornea is removed. The donor cornea has to be sutured to what remains of the host cornea. In the 2nd photo you can see the sutures joining the donor cornea to the host cornea. The corneal surgeon who referred this patient to me felt that during the transplant surgery the weakened RK cornea would fall apart and that there would not be a healthy reliable host cornea for the donor cornea to adhere to.

Flat RK Cornea

This is a profile view of an eye that underwent Radial Keratotomy (RK) surgery 30 years ago. The wide grey-white lines seen here are the open RK incisions, still open after all these years. Note how flat this cornea is. It is so flat that no contact lens, rigid or soft can adhere to the surface of this cornea. In addition, eye glasses are not able to provide this patient with functional vision in this eye. The patient's uncorrected vision in this eye is less than 20/800. With a scleral lens, this patient is able to obtain functional vision once again. There is no surgical procedure that will undo the damage to this eye caused by RK surgery. In addition, the corneal surgeon who referred this patient to our office declined to perform a corneal transplant surgery on this eye due to the magnitude ( width, length and depth) of the RK incisions.

RK followed by ALK

The 2 images below are of the same eye. This eye underwent Radial Keratotomy about 30 years ago followed by a form of LASIK surgery known as ALK (Automated Lamellar Keratoplasty). In the photo below a special dye (fluorescein) was instilled onto the ocular surface to highlight the defects and breaks on the cornea. The horizontal and oblique green lines are the open RK incisions. Look carefully and you can see a light green circular line going around the pupil. This is the outline of the ALK flap. ALK surgery is no longer being done in the U.S. The 2nd image was taken with a technology known as "Optical Coherence Tomography" or OCT. This image shows a scleral lens over this cornea. The thick curved grey structure is the cornea. Look carefully in the center of the cornea and you can see the outline of the ALK flap. This cornea is extremely dry and irregular. With a scleral lens this patient is able to see clearly and comfortably. In addition, the scleral lens protects the damaged cornea from the blinking action of the eyelids and the environment.

RK Thirty Years Ago

This is a photo of an eye that underwent Radial Keratotomy (RK) about 30 years ago. Fluorescein dye was instilled on the ocular surface to make the RK incisions more visible. Note the yellow-green dye within the deep RK incisions. This tells you that these incisions never closed. In addition, virtually every post-RK cornea is irregular and dry. Last year this eye underwent cataract surgery. During the surgery, the vertical incision extending downward from 12:00 ruptured forcing the cataract surgeon to suture the open wound. Note the increased staining in the superior portion of this cornea. Without correction, this patient not only has poor vision with this eye but also extreme discomfort (burning, dryness etc.). This patient is now wearing a scleral lens on this eye which is not only protecting this compromised eye from the environment and the blinking action of the eyelids but also providing this patient with clear, stable vision once again. Scleral lenses are now the "standard of care" when it comes to treating post-refractive surgical corneas. That is corneas that have been altered by LASIK, Radial Keratotomy and a host of other harmful, unnecessary surgeries.

Two eyes - RK and Lasik

The 2 photos below are of eyes that underwent refractive surgeries. The eye in the first photo underwent Radial Keratotomy (RK) eye surgery over 30 years ago followed by LASIK about 15 years later. Several years after the LASIK this patient lost vision suddenly. Post-LASIK ectasia was the cause of the vision loss. Shortly after the ectasia was diagnosed, this eye developed a condition known as "hydrops". This is a condition where the most posterior corneal membrane ruptures allowing fluid from within the eye to enter the cornea creating a scarred appearance. In this photo, the white oval scar that you see is the result of the "hydrops". Also note the numerous blood vessels that have spread throughout the cornea. A healthy cornea is devoid of all blood vessels. This eye was fit with a scleral lens (seen in this photo) which has provided a significant amount of vision improvement. The 2nd photo seen below is of an eye that underwent Radial Keratotomy (RK) many years ago. About 20 years after undergoing this surgery, this patient's cornea became infected and inflamed and needed to be replaced with a new cornea. The end result was a total of 4 corneal transplant surgeries that were done on this eye. This is a photo of the 4th transplanted cornea which is failing and will need to be replaced. There is no functional vision in this eye.

RK Thirty Years Ago with Extreme Discomfort. Seeing Clearly with GVR Scleral Lens

This is a photo of an eye that underwent Radial Keratotomy (RK) about 30 years ago. Fluorescein dye was instilled on the ocular surface to make the RK incisions more visible. Note the yellow-green dye within the deep RK incisions. This tells you that these incisions never closed. In addition, virtually every post-RK cornea is irregular and dry. Last year this eye underwent cataract surgery. During the surgery, the vertical incision extending downward from 12:00 ruptured forcing the cataract surgeon to suture the open wound. Note the increased staining in the superior portion of this cornea. Without correction, this patient not only has poor vision with this eye but also extreme discomfort (burning, dryness etc.). This patient is now wearing a scleral lens on this eye which is not only protecting this compromised eye from the environment and the blinking action of the eyelids but also providing this patient with clear, stable vision once again. Scleral lenses are now the "standard of care" when it comes to treating post-refractive surgical corneas. That is corneas that have been altered by LASIK, Radial Keratotomy and a host of other harmful, unnecessary surgeries.

Radial Keratotomy Corrected to 20/100 with Glasses, now 20/20 with GVR Scleral Lens

This is a photo of me with my patient Ricardo, who has been visiting our practice from Guatemala for the past 10 years on a yearly basis for his annual eye examinations. About 30 years ago, Ricardo underwent Radial Keratotomy surgery in both eyes. While his vision at first was quite good for the first few years, his vision gradually started to deteriorate. When I first met Ricardo, he was wearing eyeglasses which were providing him with 20/100 vision with a lot of visual distortions. He tried to wear various contact lens designs which were either uncomfortable or were unable to provide him with functional vision. 10 years ago, we fit Ricardo with GVR Scleral lenses. With these lenses Ricardo has clear (20/20) vision both at distance and close up and is able wear his lenses all day comfortably. Over the past 10 years we have only had to make a few changes to his scleral lenses. The 2nd photo seen below shows a close up view of Ricardo's open RK incisions. Note the blood vessel growth along the incisions. The last image was taken with a technology known as "Optical Coherence Tomography" or OCT. In this image the top 2 curves lines represent the front and back surfaces of the scleral lens. The large grey structure going left to right is the cornea. Note the wide, open break in the cornea on the right side of the image. This is an open RK incision that will never heal. Ricardo's scleral lens protects this eye from the blinking action of the eyelids and from the environment. In addition, because of the liquid reservoir between the back surface of the lens and the front surface of the cornea, Ricardo's eye is always in a moist environment. I expect Ricardo to be able to wear his scleral lenses for many years with excellent comfort and vision.

Radial Keratotomy on Transplanted Cornea now 20/30 with GVR Scleral Lens

What was the surgeon thinking when he did this surgery? What you see in this photo is an eye with a transplanted cornea that later underwent Radial Keratotomy surgery. For many years after, this eye was legally blind since no spectacle lens or contact lens was able to provide this patient with functional vision. Eventually this eye was fit with a scleral lens which is allowing this patient to see 20/30 with comfortable vision with this eye.

Radial Keratotomy Incisions Bursted During Cataract Surgery. Patient 20/25 with GVR Scleral Lens

This eye underwent Radial Keratotomy (RK) surgery in the 1980's. Last year cataract surgery was done on this eye. During the cataract surgery, the open RK incision extending downward vertically from 12:00 O'Clock burst open requiring suturing in this part of the cornea. This photo shows the open RK incisions extending from the edge of the cornea toward the center. Note the scarring and blood vessel growth at the top of the photo. When this patient was seen in our office, this eye was very red and painful. In addition, the cornea is very distorted and irregular. This eye was fit with a scleral lens which is providing the patient with 20/25 vision without any distortions. To patients unfamiliar with refractive surgery complications, just know that the people who brought you Radial Keratotomy surgery are the same people who are bringing you LASIK, PRK, SMILE, CK, ALK and so on. Unnecessary elective surgeries done today may create untold havoc many years down the road. This eye is protected by the scleral lens and is no longer painful

Radial Keratotomy, then Lasik, then Transplant, now 20/25 with GVR Scleral Lens

These are photos of the same eye. In 1993, this eye underwent Radial Keratotomy surgery for the elimination of myopia and astigmatism. When the vision in this eye began deteriorating several years later LASIK surgery was done. The LASIK surgery following the RK surgery turned out to be disastrous, visually for this patient. In 2010, corneal transplant surgery was done in an effort to restore vision. For 6 years, this eye was unable to tolerate any form of soft or rigid contact lens. This eye was recently fit with a gas permeable scleral lens which is now allowing this patient to see 20/25 with this eye. The photo below is a frontal view of the new scleral lens over the transplanted cornea. The 2nd photo is a profile view of the same transplanted cornea. The center of gravity of this cornea is so far out that it is not possible for any contact lens to remain stable on this eye. For this reason a well fit scleral lens can provide lens stability and ocular comfort while at the same time restoring excellent vision once again.

RK Patient Happy for 20 Years, Then 20/50 and 20/200 and Uncorrectable. Now 20/20 with GVR Scleral Lens

The woman standing next to me underwent Radial Keratotomy (RK) surgery over 25 years ago. This surgery involves making radial incisions onto the corneal surface from the center of the cornea unto the periphery much like the spokes on a bicycle wheel. For 20 years, this patient was satisfied with her vision. Over the last 5 or 6 years her vision began to fluctuate and to deteriorate. When this patient first came in, her corrected vision was 20/50 in one eye and less than 20/200 in the other eye. We fit both of this patient's eyes with GVR Scleral lenses which are allowing her to see 20/20 in each eye with all day comfort. In the photo below, you can see the open RK incisions. These incisions will always remain open. The scleral lenses that were provided to this patient will not only correct her vision but also protect her corneas and keep them in a wet environment.

Happy with RK for 11 Years, then Struggling due to Declining Vision, Now 20/20 with GVR Scleral Lens

The patient in this photo underwent Radial Keratotomy (RK) surgery in both eyes in 1990. For 11 years he was very happy with his post RK vision. In 2001 his vision began to fail, requiring him to wear eyeglasses which needed to be changed quite frequently. As the years went by he needed stronger and stronger eyeglasses. Over a 14 year period he struggled with a variety of both soft and hard contact lenses which were not only very uncomfortable but provided him with unstable vision. When this patient first visited our office several months ago, he required over +10.00 diopters of spectacle correction to get him to see the 20/30 line with significant distortions. 6 weeks ago we fit this patient with GVR Scleral lenses. With his new scleral lenses this patient can see clearly (20/20) and comfortably with all day lens wear and without any distortions. In the photo below note the numerous RK incisions which remain open and unhealed to this day. I feel that this patient will be able to wear his scleral lenses comfortably with clear, stable undistorted vision for many years to come.

Radial Keratotomy in 1998, Lasik in 2002, Followed by Ectasia, has Six Years Good Vision with GVR Scleral Lens

This patient underwent Radial Keratotomy (R-K) surgery in both eyes in 1988. Several years later her vision began to deteriorate and in the following years was not able to obtain satisfactory vision with either eyeglasses or contact lenses. In 2002, she visited another corneal surgeon who encouraged her to undergo LASIK surgery to correct her distorted corneas created by the R-K surgery. Shortly afterwards, a condition known as post-LASIK corneal ectasia took place. This condition is a risk factor in patients who have undergone LASIK surgery, however, the risk of this developing is much greater in patients who have undergone prior refractive surgeries such as R-K. Corneal Ectasia involves a protrusion of the front surface of the eye (the cornea). This patient's cornea was not only extremely distorted, she also suffered from chronic dry eyes and ocular pain. Due to the significant pain she had been experiencing and her inability to obtain functional vision with eyeglasses, this patient visited our office 6 years ago seeking help. 6 years ago we fit this patient with GVR Scleral lenses which have provided her with clear, stable vision. Today, this patient came in for her yearly comprehensive eye and lens evaluation. Both of her corneas have remained stable and she is seeing clearly and comfortably with all day lens wear. Below the photo of this patient with me can be seen photos of her right and left eye with her Scleral lenses over her scarred corneas. If you look carefully you can see the R-K incisions. Next to these photos is a photo of her right cornea without a lens in place. A dye was instilled onto the front surface of her eye to demonstrate the open R-K incisions along with the LASIK flap. The straight lines in the cornea are the R-K incisions which still remain open after all these years. One can tell they are open because the dye can be seen within the corneal incisions. The round circular line going around the periphery of the cornea is the LASIK flap incision. This patient will need to be seen at least once each year to make certain that infection does not occur and that her corneas remain clear and stable.

RK Patient from Chile Seeing Well For Five Years with Scleral Lens

The photo below is of my patient David on the right with his wife, Patty in the center. David and Patty traveled to see us from Santiago, Chile. David underwent Radial Keratotomy surgery (R-K) in 1989 followed by LASIK surgery a number of years later. What resulted from these surgeries were severely distorted corneas along with a very dry eye. Without corrective lenses, David has no functional vision (less than 20/800). Eyeglasses and conventional contact lenses will not allow him to see correctly. 5 years ago, we fit David with GVR Scleral lenses. For the first time in many years, David has been able to see clearly and comfortably once again. Every year for the past 5 years, David has returned to Miami to visit our office for yearly examinations. Over the years, David's vision has remained clear and his corneas have remained stable. In addition,because David's scleral lenses keep his corneas in a liquid environment, he no longer has any dry eye symptoms. Before visiting us, 5 years ago, David was told that his only hope for clear vision was to undergo corneal transplant surgery. Based on how well David has done with his scleral lenses over the last 5 years, I don't feel that he will ever need to undergo corneal transplant surgery. The lower photo is David's right cornea with a GVR Scleral lens over it. The semi-round white cloudy spot below his pupil is due to a break or tear in the back surface of his cornea. This tear took place because his cornea became very pronounced over the years following his surgeries. When this happened fluid from inside the eye entered the cornea and created this milky-white spot. This condition is called "hydrops".

Fluctuating Radial Keratomy Vision Corrected to 20/20 with GVR Scleral Lens

The patient in this photo underwent Radial Keratotomy (R-K) eye surgery in 1990 for the purpose of eliminating his myopia and astigmatism and his dependence on eyeglasses. For many years his post-surgical vision was very good. In recent years his vision began to deteriorate. He noticed that his vision was not stable and would fluctuate depending on the day, the time of the day and the surrounding lighting conditions. Last year he underwent Collagen Cross-Linking treatment in both eyes in an effort to stabilize his corneas and to improve his uncorrected visual acuity. Six weeks ago we fit this patient with GVR Scleral lenses. For the first time in many years he is seeing clearly (20/20) and comfortably with all day lens wear. In addition, his vision is stable regardless of the surrounding lighting conditions. In the lower photo can be seen the deeply scarred R-K incisions in his cornea. These incisions are still open 25 years after the R-K surgery was done. Over this scarred cornea is a GVR Scleral lens. In addition to allowing this eye to see clearly once again, this scleral lens protects the compromised cornea from the environment and the blinking action of the eyelids.

Radial Keratotomy Patient Seeing 20/20 Comfortably with GVR Scleral Lens

This patient underwent Radial Keratotomy eye surgery in 1992 in an effort to eliminate her need for eyeglasses. She saw relatively well until 2012 when she noticed that her vision deteriorated very rapidly. She visited a number of eye clinics seeking help in restoring her vision. The eyeglasses and contact lenses that were prescribed for her were unable to provide her with functional vision. In October, 2012 she visited a corneal surgeon for a LASIK surgical consultation. This corneal surgeon declined to do LASIK telling her that she faced a greater risk for further vision loss with any additional refractive surgical procedures. In November, 2012, this patient visited our office. We examined her and fit both eyes with GVR Scleral lenses. With these special lenses, this patient can see clearly (20/20) and comfortably once again with all day lens wear. For the past several years both corneas have remained stable. The 2 photos below show her corneas with open incisions. The green color is due to a special dye that we instilled in her eyes. This view is taken through a microscope with a filter placed before each eye. Radial Keratotomy (R-K) incisions typically remain open and do not heal.The bright green linear lines are the open R-K incisions that have not healed 20+ years following her R-K surgery. Because of this, there is a life long risk of corneal and other intra-ocular infections. The scleral lenses that we designed for her not only provide this patient with excellent vision but also protect her corneas from infections and possible ocular trauma. In addition, because there is a liquid reservoir between the back surface of the lenses and the front surface of her corneas (the lenses do not touch the corneas) her corneas will always be in a liquid environment and not be dry.

Three RKs, Wide and Deep Incisions, Patient Seeing Clearly and Comfortably All Day with GVR Scleral Lens

This patient underwent 3 separate Radial Keratotomy surgeries over a 12 month period. These eye surgeries took place over 25 years ago. This patient's vision deteriorated with each successive surgical procedure. When first seen in our office, her corneas were extremely distorted and "beaten up." Both corneas had numerous wide, deep and open incisions. In addition to blurred distorted vision, this patient was so photophobic that she had to wear 2 pair of sunglasses (one over the other) to subdue to light so that she could function even indoors. The image below and to the left is an image of one of her corneas with a GVR Scleral lens over it. Note the open incisions to the right and left side of the image. The colored images below and to the right are her corneal topographies. The varying shades and colors represent the many elevations and depressions of her corneal surfaces. 3 years ago we fit this patient with GVR Scleral lenses. With these lenses she is able to see clearly and comfortably with all day wear. In addition, she is no longer photophobic (light sensitive) and does not need to wear sunglasses indoors since receiving her lenses.

Deteriorating RK Vision Advised for Transplant now 20/20 with GVR Scleral Lens

This patient visited our office from Guatemala. In 1990 he underwent 2 separate radial keratotomy (RK) surgeries in an attempt to eliminate his myopia. While his vision was improved for a period of years, eventually his vision began to deteriorate. When his vision could not be corrected any longer with eyeglasses or contact lenses, he visited a number of corneal specialists both in his country and in the United States for help. After being told that his only option would be corneal transplant surgery, he visited our office in 2008 for another opinion. If you look carefully at the attached images, you will see that his RK incisions are still open after all these years. The cross sectional corneal image shows a GVR Scleral lens over his cornea with an open incision that nearly perforated the cornea. Since 2008 he has been wearing his GVR Scleral lenses comfortably with all day wear and with 20/20 vision without any visual distortions. This patient will never need corneal transplant surgery.

Radial Keratotomy Patient Advised to Seek Transplant now 20/20 in Each Eye with GVR Scleral Lens

This patient visited out office last year from Argentina. 25 years ago he underwent 2 separate Radial Keratotomy surgeries in each eye followed by LASIK surgery in each eye in 2002. Over the years his best corrected visual acuity deteriorated to less than 20/50 in each eye with eyeglasses and contact lenses. After being told that he needed bilateral corneal transplants, he decided to visit us for a 2nd opinion. If you look carefully at the photos placed here you will notice that the RK incisions never healed but remained open. In addition all of these elective surgeries left both corneas extremely distorted and very dry. 15 months ago we fit this patient with GVR Scleral lenses. These lenses act as new corneas and are providing this patient with stable, clear (20/20) vision in each eye with excellent all day comfort. In addition, because these lenses vault over the corneas and keep the corneas in a liquid environment, dry eyes are no longer an issue.

Unstable Radial Keratotomy Cornea has Distortions Fixed by GVR Scleral Lens

In the 1988, this eye underwent an eye surgery known as Radial Keratotomy. Deep slices or incisions were made into the cornea in an effort to reduce this patient's dependance on eyeglasses and contact lenses. What took place instead was a large visual error (prescription) that became increasingly unstable and not correctable with eyeglasses or contact lenses. In addition, this eye presented the patient with halos, glare, light sensitivity and double vision. Look carefully and you will note blood vessels growing onto the cornea, where blood vessels do not belong. Several years ago we fit this eye with a GVR Scleral lens which has eliminated all of the visual distortions created by this surgery. In addition, the patient is no longer light sensitive. Because this lens acts as both a protective and therapeutic device we are hopeful that the growth of blood vessels onto the cornea will stop and hopefully recede.

Deteriorating Vision After RK for Police Officer, now 20/20 with GVR Scleral Lens

This police officer underwent several Radial Keratotomy eye surgeries in 1988. As the years went by his vision began to deteriorate to the point where he could no longer do his work. He went to a number of eye clinics and eye institutions seeking help but was told that his only choice was to undergo corneal transplant surgery. Contact lenses proved painful and eyeglasses were not able to provide him with functional vision. In addition his vision was constantly changing during he day. At night he was experiencing halos, glare and multiple images with each eye. Last year we fit this office with GVR lenses. Since last year his vision has been stable. He can see clearly (20/20) during the day and at night without glare, halos or multiple images. In addition, he is able to wear his lenses all day comfortably without any eye irritation or redness.

Radial Keratotomy Equals Pain and Blurry Vision, but Clear and Comfortable with GVR Scleral Lens

This patient had 2 separate R-K (Radial Keratotomy) eye surgeries done in the 1980's. What followed were years of painfully red eyes along with blurred, distorted vision. Over the years she visited a number of eye clinics and institutions that provided her with many types of contact lenses and eyeglasses. None of these items provided her with functional vision. 6 years ago we examined this patient and fit her with GVR Scleral lenses. For the past 6 years she has had clear, undistorted functional vision. In addition she is able to wear her scleral lenses all day comfortably and her eyes are no longer red.

Radial Keratotomy followed by Lasik Equals More Vision Loss, now 20/20 with GVR Scleral Lens

The young woman in the middle of this photo lost quality vision and comfort due to Radial Keratotomy surgery done in the 1980's followed by LASIK surgery a number of years later. When her vision began to fail following Radial Keratotomy, she was told by a LASIK surgeon that LASIK would improve her vision. What took place was additional vision loss, and a very deep depression when no one in her community was able to help her regain her vision. 4 years ago, this patient visited us seeking help. At the initial visit we fit her with GVR Scleral lenses which have allowed her to see clearly (20/20) once again with excellent comfort and all day wear. The young lady to my patient's left is her little sister who accompanied my patient to Miami for her annual eye and vision examination.

Radial Keratotomy Produces Dry, Irregular Cornea, now 20/20 Each Eye with GVR Scleral Lens

This is a photo of our student extern David Yoo with a patient who visited our office from Guatemala. In the 1980's this patient underwent Radial Keratotomy (RK) eye surgery which created a very distorted, irregular and dry corneal surface. In addition, both corneas have large, deep open incisions which never healed. When this patient first came to visit us, her best corrected visual acuity was very poor. We provided this patient with GVR Scleral lenses which are now allowing her to see close to 20/20 in each eye. However, this patient's open incisions will require us to make ongoing lens changes over the next few months to improve the quality of her vision and her comfort. Almost all patients who underwent RK surgery have open incisions which expose the corneal sensory nerves to the environment. The GVR Scleral lenses will protect the compromised cornea and help to promote healing.

Radial Keratotomy Patient with Diminished Vision now 20/20 with GVR Scleral Lens

During the 1980s this patient underwent 3 separate Radial Keratotomy surgeries in an effort to eliminate his myopia and astigmatism. As the years went by his vision gradually started to deteriorate. His decreased vision was not correctable with either eyeglasses or contact lenses. Seeking an answer to his diminished vision, he visited several nationally renown eye institutions in 2001. Eventually one of these facilities performed 2 separate LASIK procedures over an 18 month period. The result of these 5 separate refractive surgeries was horribly distorted corneas with open R-K incisions, ocular pain and ever changing vision. 4 years ago we fit this patient with GVR Scleral lenses which have provided him with clear (20/20 vision), stable vision with all day comfort. Because these lenses also protect the injured corneas from the blinking action of the eyelids and the environment, he no longer has any ocular pain.

Radial Keratomy Patient with Pain, Distortions now 20/20 and Distortion-Free

In the 1980's, this patient underwent 4 separate radial keratotomy surgeries in her right eye and 3 separate radial keratotomy surgeries in her left eye. For many years she suffered from pain in both eyes, visual distortions in both eyes and daily changes in her vision. In the years following her surgeries she visited a number of eye institutions seeking help only to be told that she would need corneal transplant surgery in both eyes. In 2010 she was examined in our office and fit with GVR Scleral lenses. For the past 5 years, she has been able to wear her lenses comfortably all day, with clear 20/20 vision and without any vision distortions.

RK followed by Lasik Advised to Have Transplant, Avoids Transplant with GVR Scleral Lens

In the 1980's this patient underwent several separate Radial Keratotomy surgeries in an attempt to eliminate her myopia and to improve her vision. When this failed, she underwent 2 separate LASIK procedures 15 years later. She went to a world renown eye institution about 12 years ago seeking help to restore her lost vision. They were unable to help her and informed her that her only option was to undergo corneal transplant surgery in each eye. We have been working with this patient diligently for the past 8 years trying every known lens design and material in existence in an effort to give her clear, comfortable vision with all day wear. Last year we fit her with a new GVR lens design which is providing her with what our goal initially was. She now has clear, comfortable vision with all day lens wear. I feel that she will never need to undergo corneal transplant surgery in either eye.

RK Patient now 20/20 with GVR Scleral Lens

This patient underwent Radial Keratotomy surgery in both eyes in the 1980's followed by LASIK surgery in her left eye in 2003. For many years she suffered from blurred, unstable vision which could not be corrected with eyeglasses or contact lenses. In addition she suffered from significant ocular pain and light sensitivity. Two years ago she was fit with GVR Scleral lenses which have provided her with clear (20/20 vision),stable vision and all day comfort without any visual distortions.

ALK Complications addressed with GVR Scleral Lens

This patient (in center of photo) underwent a refractive surgical procedure known as Automated Lamellar Keratoplasty or ALK. The purpose of this surgery was to eliminate this patient's hyperopia (far sightedness) and astigmatism. For 8 years this patient was satisfied with his post-surgical vision. After 8 years during a 3 week period his vision deteriorated to the point where eyeglasses and contact lenses were unable to provide functional vision. For several years this patient visited a number of doctors who told him that his only option was to have corneal transplant surgery. 3 years ago we fit this patient with GVR Scleral lenses. With these lenses he is able to see clearly (20/20) and comfortably with all day lens wear. In the photo with the cornea immersed in dye you can see the outline of the ALK cornea flap. The lower photo to the right shows a cross section of the post-surgical cornea with the GVR Scleral lens over it. The scarring from the ALK surgery is visible in the center of the cornea. With the GVR Scleral lens, this patient will never need corneal transplant surgery. By the way, the young lady to the right is our student extern (soon to be eye doctor) Tina Cheung.

GVR scleral lens over a highly irregular RK cornea

The structural effect of the RK incisions on this cornea is clearly visible in the OCT cross-section, where an incision appears on the right.

Scleral Lens over RK incisions

Like most patients we see with RK, the incisions remain open many years later, and in fact, never heal.

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EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

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