Radial Keratotomy and Reading Glasses

If you’re among the 68 million Americans who are nearsighted, you probably wear reading glasses or contact lenses to improve your distance vision. You also may hear a lot about Radial Keratotomy (RK) and Photorefractive Keratectomy (PRK), surgical procedures that treat your vision problem.  Orthokeratology (Ortho-K), a non-surgical procedure claims to improve your vision by changing the shape of your cornea.

Don’t throw away your reading glasses or contact lenses just yet. The Federal Trade Commission (FTC) cautions that RK, PRK, and Ortho-K are not always short cuts to perfect vision, although some advertising and promotional materials for the procedures may suggest otherwise.

RK and PRK reduce nearsightedness by altering the shape of the cornea. In RK, the surgeon uses a diamond knife to make incisions in the cornea in a radial or spoke like pattern. This causes the cornea’s curvature to flatten, changing the way it focuses light on the retina. In PRK, the surgeon uses a computer-controlled excimer laser to sculpt the surface of the cornea, changing its shape and the way light is "refracted" to the retina.

RK and PRK are outpatient surgical procedures. They are not used to treat people who have trouble seeing near objects, those who are farsighted, people who need reading glasses as a result of the aging process and those who are presbyopic.

Some surgeons who perform RK schedule two operations, allowing one eye to stabilize before operating on the second. The U.S. Food and Drug Administration (FDA) recommends a three month waiting period between PRK operations. Many RK patients and a small percentage of PRK patients also need or want additional surgery, usually called an "enhancement", to fine tune the results of the initial operation. Neither RK nor PRK is considered medically necessary, because the operation is performed on a healthy organ. As a result, the surgery usually is not covered by health insurance.

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