CK or Conductive Keratoplasty Eye Surgery

At Dr. Nahl's elegantly appointed laser eye surgery San Diego facility, patients are offered a range of sophisticated refractive procedures. In addition to performing LASIK, LASEK and PRK, Dr. Nahl also offers CK in San Diego. Also referred to as conductive keratoplasty, this procedure uses gentle radio waves to reshape a patient’s corneas and improve his or her vision. As a highly experienced San Diego CK surgeon, Dr. Nahl recommends and performs this procedure for farsighted patients who desire to achieve clear vision without glasses. Please read on to learn more about CK in San Diego.

Conductive keratoplasty (CK) is a relatively new type of refractive surgery that uses mild heat from radio waves to shrink the glue-like connective tissue (collagen) in the periphery of the cornea.

This steepens the cornea, giving farsighted patients with presbyopia better near and distance vision while improving near vision for patients with presbyopia alone.

If you are nearsighted, CK is not for you, although expanded indications such as for astigmatism correction are being studied.

Better surgical techniques and technology now address earlier problems with CK in that some corneas tended to revert to original states and vision corrections failed to remain stable (regression).

Conductive Keratoplasty, the Radio Waves Eye Surgery

Conductive keratoplasty received FDA approval in April 2002 for people 40 or older with mild farsightedness. In 2004, expanded FDA approval included presbyopia, a condition that develops beginning about middle age in which your eye's natural (crystalline) lens stiffens and can no longer focus at near, middle, and distant ranges at the same time. CK correction for presbyopia differs from hyperopia in that only one eye (the non-dominant eye) is corrected for near vision, while the other eye is left untreated.

After someone with presbyopia receives CK, the treated eye is able to see at near ranges, while the untreated eye sees at middle to distant ranges.

Candidates for this type of vision correction, known as monovision, may be asked first to wear contact lenses for near vision correction to make sure they are able to adapt. But this is not a requirement. We instead might hold a +1.00 lens for near vision correction in front of the non-dominant eye to see if the person experiences significant distance blur at a distance with both eyes open. People who do not have blurry distance vision under these circumstances likely are very good candidates for CK.

CK offers a major advantage in that the procedure is less likely to blur distance vision with monovision correction than contact lenses or laser vision correction.

CK uses heat from radio frequency waves to shrink collagen and change the shape of the cornea. We use a hand-piece containing a tiny, pen-shaped probe (Keratoplasty Tip) that releases the frequency over the periphery of the cornea. The procedure takes about 15 minutes.

To qualify for CK correction of hyperopia, you must be 40 or older and have between +0.75 and +3.25 diopters of refractive error, with no more than 0.75 diopters of astigmatism. Also, your glasses or contact lens prescription cannot have changed within one year before the surgery.

To make sure CK correction of presbyopia is right for you, we may test you with a trial period of wearing monovision contact lenses in which one eye is corrected for near vision and the other eye is corrected for far vision or we may determine if you are a good candidate for monovision correction by holding a test lens in front of your non-dominant eye to make sure your distance vision remains sharp.

CK treatment parameters for presbyopia allow induction of myopia in the eye being corrected for near vision between a range of -1.00 to -2.00 diopters. As with hyperopia correction, your glasses or contact lens prescription cannot have changed within one year before the surgery.

Before CK Surgery

We will examine your eyes to determine your exact refractive error and how much corneal shrinkage is necessary to correct it. An instrument called a corneal topographer photographs your eye and creates a curvature map of your cornea. The corneal topography map will display the various steep and flat corneal curvatures that we must take into consideration.

During CK Eye Surgery

We will insert a few anesthetic eye drops into your eyes, then apply a special tool often resembling a pair of kitchen tongs (speculum) between the eyelids to prop them open and prevent blinking.

In CK, the speculum also serves as a return path (that is, a ground) for the radio frequency produced by the probe. Using a rinse-away dye, we will imprint a treatment pattern on your cornea, showing where the radio frequency should be applied. Only a few seconds of the treatment are required for each eye.

CK is painless, but some people say they feel a slight pressure on the eye.

Both eyes can be done during the same visit (if you are being treated for hyperopia), so there is virtually no down time.

After CK

We will give you a prescription for eye drops that help prevent infection and reduce inflammation. We may ask you to wear special bandage contact lenses for a few days to minimize discomfort.

In conductive keratoplasty, low heat energy from radio frequency is applied through a probe to reshape your eye's surface.

You can leave the doctor's office right after CK, although someone else must drive you home.

You may experience a foreign body sensation when the topical anesthetic wears off (about 20 to 30 minutes after the procedure), similar to the feeling of a piece of dirt or debris in your eye. Although you will be able to function normally, for the first week you may be slightly nearsighted. However, these side effects should clear up quickly. You also may find your eyes are sensitive to bright light. Wearing sunglasses for up to one week is sometimes necessary.

If you wear a pacemaker for regulating your heart or similar electronic equipment, you should not undergo CK because of the possibility that radio frequency waves will interfere with its proper function.

In addition to performing CK and various forms of laser eye surgery, Dr. Angela Nahl specializes in premium IOLs cataract surgery. During this procedure, she removes patients’ clouded lenses and replaces them with high quality intraocular lens implants (IOLs). Dr. Nahl has multiple years' experience with premium IOLs, and she has helped numerous ReStor, ReZoom and Crystalens San Diego patients achieve clear vision while reducing their dependence on glasses. Dr. Nahl also offers implantable contact lenses (ICL) for younger patients who wish to achieve freedom from glasses but do not qualify for LASIK. In fact, she is regarded as one of the most accomplished ICL San Diego surgeons.