Conductive Keratoplasty for Near Vision – does it work and for how long?
Conductive Keratoplasty, (CK) is used to treat farsightedness or create a nearsighted refractive effect by using a radiofrequency heat-activated probe that is inserted into the cornea. This induces shrinkage of the collagen matrix, thus steepening the cornea and changing the way the eye focuses.
Steepening the cornea by heating has been around for decades, evolving from a hot needle probe to an external Holmium laser application, and most recently radiofrequency technology. However, all these techniques have resulted in what is referred to as regression or returning back to the original shape of the cornea after the initial shrinkage occurs, typically a few years later.
Although Conductive Keratoplasty has shown the least regression of any heating techniques to date, it is still considered a temporary treatment by the Food and Drug Administration (FDA). It is believed that patients will lose their near vision over years, based on regression of results of the treatment and progression of loss of near vision with age. The procedure can be repeated at a future date, but no one knows how many times this technique can be used without inducing side effects.
Patients who consider CK mono-vision discover that this reduces their far vision, resulting in reduction of their binocularity and reduction of their depth perception. For patients who have previously worn contact lenses with this correction, this may be a satisfactory alternative. For those who have not worn contact lenses for mono-vision it is highly recommended that they experiment first with contact lens use.
We perform laser vision correction or Refractive Lens Exchange (RLE) for the same patient population as those eligible for CK. The one distinction between farsighted laser vision correction and CK remains that laser vision correction is considered a permanent treatment whereas CK is considered a temporary treatment. Only one half percent of all refractive surgery performed according to a recent poll involves CK. The frequency of this procedure being performed by Ophthalmologists is declining as a result of the temporary effect.