Conductive Keratoplasty

Procedures for Conductive Keratoplasty or CK

Did you have excellent vision until you needed distance glasses at the age of 30? Did you turn 40 and find that you needed bifocals? If so, you may be among the millions of people who have presbyopia.

Presbyopia is a natural change in our eyes’ ability to focus. It occurs when the crystalline lens of the eye loses its flexibility, causing objects to appear blurry.

Until recently, only shortsighted patients have had many different procedures available to them that could be used to correct their vision problems, such as LASIK, RK and PRK. Now, one of the first non-laser procedures for presbyopia, CK (Conductive Keratoplasty), has been developed to address the symptoms and problems of older patients.

Benefits of CK

Conductive Keratoplasty or CK is a safe, non-laser, non-cutting technique approved by the FDA to reduce or eliminate presbyopia for patients over 40. Instead of a scalpel or a laser, CK releases radiofrequency (RF) energy through a probe as thin as a strand of human hair, treating your vision condition without cutting or removing tissue. The controlled release of RF energy in a circular pattern shrinks the connective tissue in the cornea to reshape it, improving the way the eye focuses light.

CK was the first FDA-approved method for treating presbyopia. It is safer and less invasive than the LASIK procedure and avoids the complications associated with LASIK treatment such as dry eyes, hazy vision, light sensitivity or poor quality of vision. It takes less than five minutes per eye and uses only a topical anesthetic. Post-operative discomfort is minimal and vision improves almost immediately.

During CK

During CK full informed consent was given, and the patients were advised that CK was being performed as an off-label non–Food and Drug Administration approved procedure. Before each operating session, the CK instrument was calibrated per the manufacturer’s recommended procedure. The axis of treatment for astigmatism corrections was marked at the slit lamp with a tissue marking pen.

After the patient was supine on the operating table, the operative field was prepared in a sterile fashion with povidone iodine. A patch was taped over the non-treated eye to facilitate coaxial fixation by the patient. Tetracaine drops were instilled 3 times to achieve topical anesthesia. The CK lid speculum was placed. The patient was asked to look at a coaxial fixation target, and a CK marking instrument coated with gentian violet was placed centered on the pupil and properly aligned with regard to astigmatism axis.

This instrument has a 7.0-mm central ring and 8 radial posts extending to the 6.0- and 8.0-mm optical zones to guide spot placement. Cellulose sponges were used to remove any residual fluid from the surface. Conductive keratoplasty spots were applied using the gentian violet template as a guide. Care was taken to ensure that the probe was placed perpendicular to the cornea. Enough force was applied to the tip to ensure maximum penetration depth up to the stop.

After each ring was applied, the probe tip was inspected under the microscope and any epithelial debris carefully cleaned with a cellulose sponge. At the end of the procedure, prednisolone acetate 1% and an antibiotic drop were applied. The patient continued these drops 4 times daily for 1 week.