Vision Learning Center Navigation... Refractive Surgery Options   -iLASIK® (CustomVue™ blade-free LASIK with Intralase)   -RL-Refractive Lensectomy/PRELEX℠   -CK-Conductive Keratoplasty   -ICL-Verisyse™ and Staar™ Implantable Contact Lenses   -PRK-Photorefractive Keratectomy   -INTACS®-Corneal Segments   -AK-Astigmatic Keratotomy Valley Eye Report Card Financing Options Testimonials Cataracts Frequently Asked Questions Prevention Guide Insurance Information Valuable Vision Links   Conductive Keratoplasty What is Conductive Keratoplasty? Conductive Keratoplasty (or CK for short) is a procedure designed to reduce or eliminate farsightedness or compensate for presbyopia. Farsightedness, also called hyperopia, occurs when the shape of the eye is shortened so that light is focused behind the retina (the seeing part of the eye). Presbyopia describes the natural aging process of the lens within the eye. A person with presbyopia (which usually begins sometime after the age of 40) can see fine in the distance without glasses, but is unable to see near objects without reading glasses. CK corrects farsightedness or presbyopia by steepening the cornea. One to three rings of eight spots of radio-frequency energy are applied to the outer portions of the cornea, gently heating the collagen within the cornea. The heated collagen shrinks and the cornea steepens. No corneal tissue is cut or removed. CK was developed over 10 years ago. It is gaining widespread acceptance and was approved by the United States Food and Drug Administration (FDA) in April of 2001 for the correction of farsightedness and in 2004 for the correction of presbyopia. Who is a candidate for CK? It is estimated that in the United States alone, 60 million people are potential candidates for CK. Candidates for CK may experience difficulty wearing glasses and contact lenses. Some people may have tried contact lenses and have difficulty wearing them due to allergies, dryness of the eyes, astigmatism, or other irritants. Generally the best candidates have minimal hyperopia (plano to +.50 D) with no more than .75 D of astigmatism and are over the age of 45. Candidates are encouraged to attend a free educational seminar or visit Valley Eye Associates for a Free Complementary Consultation. A thorough eye examination is required prior to having CK. If there are no contraindications for CK, the next step is a "CK Evaluation". This includes interpretation of computer mapping (computed topography) of the cornea, corneal thickness measurements (pachymetry), and a counseling session. Computed topography provides a detailed surface map of the cornea to guide your surgeon in formulating a specific treatment plan. The counseling session (including meeting your surgeon face-to-face) allows patients the opportunity to have all of their questions answered. How is the procedure performed? CK is performed at Valley Eye Associates. No single formula can provide the perfect correction for everyone. That is why an individual consultation is so important in planning for CK. For example, if you spend 8 hours a day working at a computer screen, your visual needs will differ from someone who spends much of the day driving. If you are over 40, you may experience problems with your near vision focusing up close. By treating one eye, the need for reading glasses can be reduced or eliminated. This technique, called blended vision, has proven successful in helping individuals adjust with the natural aging process. Blended vision allows for better distance and intermediate vision when compared to traditional monovision. Your specific needs in terms of lifestyle and career goals are taken into consideration when the treatment plan is developed. As the accuracy of CK is not perfect, that our vision naturally degrades over the years, and that the effect may lessen with time; the surgeon will usually aim for a post-operative result where a patient is initially overcorrected. It is also important to keep in mind that farsightedness progresses as patients age, even if no treatment is performed. Because of this, for the first 1 to 3 months, the improvement of near vision will be quite rapid, but may diminish over time as distance vision improves. Vision recovery may be rapid or take several weeks or months until the best vision is obtained. If more correction is needed, additional treatments or other surgeries may be performed to improve the overall result. This approach gives you and the doctor more control over the results of CK. What if I have astigmatism? Astigmatism is a condition in which light that enters the eye is focused at more than one place inside the eye. This is caused by an irregularly shaped cornea (similar to the shape of a football). CK can be used to treat astigmatism, but this is considered by the FDA to be an off-label application of this technology. Another technique, called Astigmatic Keratotomy (or AK for short), has been performed over the last 20 years to reduce astigmatism. In this procedure, arc shaped incisions are made in the cornea. AK can be done after CK. What happens before the day of CK? Prior to your treatment date, you will receive a list of pre-operative instructions. No pre-operative history or physical examination is required by your family doctor. You are required to make arrangements for a relative or friend to drive you home after the procedure. You will be instructed to stop wearing your contact lenses 3 days prior to CK if they are soft lenses and 2-4 weeks or more prior to CK if they are hard or gas-permeable contact lenses. This is to ensure that your cornea resumes its natural shape prior to treatment. What happens the day of CK? CK is performed at Valley Eye Associates. In this relaxed atmosphere, you will receive professional and experienced care. The staff is there to answer your questions and assist you in understanding the procedure. Before CK, you will receive a topical anesthetic (numbing drop) which is all that is needed so that you will not feel discomfort during the treatment. The laser treatment itself only takes a few minutes and is performed in an operating suite with the use of an operating microscope. Antibiotic eye drops are applied without any patch at the end of the treatment. How do I care for my eye after CK? You should avoid rubbing or bumping the eye after CK. You may experience discomfort such as scratchiness, tearing, foreign body sensation, or other sensations in the eye. This is normal and may last for a few days. Pain relievers are occasionally needed and are prescribed if necessary. Women should refrain from wearing eye make-up for the first 7 days after treatment. The limitations on activities may vary from person to person. However, generally speaking, you may immediately resume normal activities like bending, watching TV, taking a shower, or reading. Contact and racquet sports should be avoided for one week after CK. Please note that we recommend that you use protective eye wear anytime you participate in racquet sports, regardless of whether or not you have had CK or other eye surgeries. What follow-up care is necessary? Patients are generally seen 1 day, 1 week, 1 month, and 6 months after CK. More frequent visits may be necessary. Visits during the first six months after surgery are included in the treatment fee. Of course, regular eye examinations by your eye care provider are essential to maintain healthy eyes. When both eyes need CK treatment, a patient is asked to wait about 1 to 3 weeks before having the other eye done. Patients referred by their optometrist will receive a portion of their post-operative care from this doctor. There is no additional fee for this service. What are the risks of CK? Clinical trials have shown CK to be extremely safe. However, as with any surgery, there is always a slight risk of post-operative infection, although this is minimized by the use of pre-operative and post-operative antibiotics. With CK there is a slight chance that the eye will be overcorrected or undercorrected, which would mean that glasses or contact lenses would be needed to obtain your best possible vision. There is a chance CK could either induce astigmatism, make existing astigmatism worse, or create irregular astigmatism. The need for glasses or contact lenses may or may not be temporary. Enhancements may be possible to improve the result. In the first weeks after surgery, you may be sensitive to bright lights or see starbursts around lights at night (glare). This usually decreases several days or weeks after surgery. Your eyes may feel irritated for a day or two after treatment. Vision fluctuation during the day is possible after CK. The vision may be temporarily affected by fatigue. This should improve in several weeks as healing progresses. This is not a complete list of all potential complications of CK. It is impossible to list all of the potential problems with this procedure that may arise immediately following treatment or months or years later. No guarantee or warranty can be made as to results or safety of CK. However, in clinical studies there were no reported adverse effects or sight-threatening complications. Will I have "Perfect Vision"? The goal of CK is to reduce your dependence on glasses or other optical aids. A small amount of correction may be needed for near vision or far vision after treatment. Contact lenses can be used after CK. The results of CK will depend on your cornea's response to the laser and the healing process. While the procedure can be done more than once, it cannot be performed an infinite number of times. How much will CK cost? You will be charged a surgeon's fee, and if applicable, a co-management fee paid directly to your optometrist or ophthalmologist, for each eye unless both eyes are done at the same time. The surgeon's fee is reduced by the co-management fee when your optometrist or ophthalmologist provides part of the post-operative care. This covers all future CK enhancements for 12 months, if necessary, and follow-up visits for six months. CK enhancements performed more than 12 months after the initial procedure are provided at a significant discount. Prior to surgery, you can meet with a financial counselor who will answer your questions about the fees. For our patients' convenience, we accept cashier checks, cash, MasterCard, VISA, and Discover. A discount for cash payment is available, as well as a 0% down, 0% interest financing plan. Payment in full is required 5 business days before the first eye is scheduled to be performed, unless a financing arrangement has been made. If payment is not received 5 business days before the procedure, the procedure will be postponed. No surgery will be done on your second eye until this fee is paid as well. Very few insurance companies cover refractive surgery. However, we do encourage you to check with your insurance provider before the surgery.