Fitting Scleral Lenses on Patients with Radial Keratotomy


Patient with dye in their eye to show Corneal incisions from radial keratotomy surgery
Corneal incisions from radial keratotomy surgery

We recently saw a patient who presented with scars from radial keratotomy (RK) surgery. I wanted to highlight this photo because this patient has a unique inferior incision (at the bottom of the photo), such that when dye is applied to the eye, it accumulates in this incision, showing how deep it is. Many RK patients have this particular inferior incision because it was used to correct astigmatism. However, because of its inferior positioning, the pressure accumulates behind this incision and pushes it out, creating a very irregular surface and poor vision.


RK was a very common surgery that was performed in 1980s/1990s. This surgery provided clear vision for many years for most patients, but with time, the front of the eye tends to be weakened by the incisions, pressure behind the eye changes, and patients experience vision fluctuations, increasingly high prescriptions (generally farsighted and astigmatism), quickly changing glasses prescriptions, and starbursts/halos around lights (particularly at night).


As a contact lens specialist, I see many RK patients with these inferior large gaping incisions/wounds. It is important to fit contact lenses so they are not rubbing on this wound. Sometimes lenses can look great but the wound is too close to the mid-periphery of the contact lens and this will present problems with comfort and visual acuity in the future.


This particular patient was fit with conventional scleral lenses in both eyes. When we first saw them, they saw 20/30 in the right eye and 20/200 in the left eye. With scleral lenses, they now see 20/20 with both eyes and feel their vision has improved greatly. We are very happy with these results for them and look forward to monitoring their progress!


Have you experienced any vision complications from radial keratotomy surgery? Call 480-420-4243 or drop us a note here to see if custom-designed scleral lenses could help you.


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