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.