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.