Four Lasiks and Conductive Keratoplasty, now 20/20 in Each Eye with GVR Scleral Lens

This patient recently visited our office from Portugal. Over a 12 year period beginning in 2004 he underwent 4 separate LASIK surgeries and 1 conductive keratoplasty procedure (CK) all in his right eye. In 2004, he underwent LASIK surgery in his left eye. In conductive keratoplasty, a probe utilizing radio frequency energy is inserted into the corneal periphery in spots corresponding to the numbers on a clock. Each successive surgery made the vision in this patient’s right eye worse than the preceding surgery. When this patient first entered our office his entering visual acuity was 20/40 in his right eye ( with distortions, shadows, starbursts etc.) and 20/25 in his left eye also with shadows. Over a 2 week period we fit both of this patient’s eyes with GVR Scleral lenses. A number of lens changes needed to be made (over a 2 week period) to optimize the lens fit and eliminate the shadows he was seeing, especially in his right eye. With the lenses he went home with he was able to see clearly (20/20) in each eye. The shadows and distortions that he was seeing (mainly at night) were eliminated in his left eye and greatly reduced in his right eye. My feeling is that the greatly reduced higher order aberrations that this patient had been seeing in his right eye was caused for the most part by the natural lens within his right eye and not by the scleral lens. In any case, I am working with several lens technologies to address the remaining issues with the night time shadows that this patient is experiencing with his right eye. Overall, this patient is seeing significantly clearer and more comfortably now for the first time since undergoing his LASIK surgeries and the CK procedure. In the photo below I am standing next to this most interesting patient. Below this is a photo of this patient’s right eye taken through a bio-microscope. A special dye is used to highlight details on the corneal surface. The bright green tinted curved line going around the corneal periphery is the first LASIK flap border. A fainter curved line several mm within the cornea is the 2nd LASIK flap border. Note the round spots appearing around this LASIK flap going around the corneal periphery like the numbers on a clock. These are the permanent spots created by the CK probe. It must be understood that there are no surgical or other invasive procedures that will undo the damage caused by the LASIK and CK procedures performed on this patient. Scleral lenses are the best non-invasive options that will allow this unique patient population to see clearly and comfortably once again.

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