How is CK performed?
CK is uses a small probe, thinner than a strand of human hair, to release controlled radio frequency (RF) energy to reshape the cornea. The probe is applied in a circular pattern on the outer cornea to shrink small areas of tissue. This circular shrinkage pattern creates a constrictive band (somewhat like tightening a belt) increasing the overall curvature of the cornea. The procedure takes less than three minutes and is done in our office using only anesthetic eye drops.
Will you be cutting the cornea?
No. CK is a safe, minimally invasive procedure for farsightedness, performed without cutting or removal of tissue
Are any needles or stitches used during the procedure?
No. Numbing eye drops are used prior to the procedure to ensure that you do not experience any pain during the treatment. This is a minimally invasive procedure and no cutting of tissue is involved, so no stitches are required for recovery.
Will I be awake for the procedure?
Yes. It is important that the patient be awake for the procedure so that you are able to focus on the light and maintain a steady gaze. You will be given a sedative to calm your nerves, however you will remain awake throughout the procedure.
How long does the procedure take?
You will be in the office approximately 1.5 hours on treatment day. The actual procedure time is only five minutes and goes by rather quickly. You will need to arrange to have someone drive you home from the procedure as your eyes will still be adjusting to the treatment.
Is radio frequency (RF) safe for use on the eye?
Yes. One of the most advanced surgical techniques available, RF energy is also used in prostate cancer therapy, back surgery, even cardiovascular procedures.
Will my vision improve immediately after surgery?
No. It usually takes several weeks for the eyes to heal, and up to three months to achieve the full, final level of treatment.
Will my vision fluctuate after surgery is performed?
Yes, and it is very important to have realistic expectations: most patients experience some vision fluctuation. This may range from mild to very noticeable and can be frustrating, but it will usually subside within several weeks. It is important to know that CK treatment requires a significantly longer stabilization period than most procedures for nearsightedness, and will not achieve "instant" results. After three to four weeks most patients are comfortable with their vision. By three months patients are overwhelmingly happy with the outcome.
Are both eyes treated on the same day?
Yes, for patients who require treatment in both eyes CK is performed one eye after another on the same day. Most patients are comfortable having both eyes done on the same day because the procedure is minimally invasive, takes less than three minutes and is done with only topical anesthesia.
Will I have to wear patches over my eyes after the CK procedure?
No, you will not need patches or bandages. Some surgeons recommend temporary clear lenses, similar to contact lenses without a prescriptions, to protect the eyes and reduce any potential discomfort. You may experience some light sensitivity, and may need to wear dark glasses during the first few days of recovery.
How soon can I return to work?
We recommend taking a few days off work because during the first week vision fluctuations tend to be most bothersome. You will return to our office for a two-day post-operative exam so that the doctor can check your progress. Though recovery is fairly quick, it is advisable to be careful with your eyes and avoid any strain during this initial period.
What will I feel during the CK procedure?
CK is typically a painless procedure. You may be aware of a support (speculum), which helps to hold your eye open. The most common sensation that patients experience is a feeling of pressure on the eye.
What type of anesthesia is used during the CK procedure?
A very effective local anesthetic in the form of eye drops is used to numb the eye.
Why doesn't CK use a laser?
CK is the first alternative to laser for farsightedness. Rather than removing tissue with a laser, CK reshapes the cornea using an entirely different method. The application of low-level radio frequency energy is applied in a circular pattern on the outer cornea, to shrink small areas of corneal tissue. This circular pattern acts like a belt tightening around the cornea to increase its overall curvature. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia.
Will the instrument used in the CK procedure penetrate my cornea?
CK is performed using a probe that is as thin as a strand of human hair. The probe, introduced into the cornea, applies controlled radio frequency (RF) energy, stabilizes the CK procedure, and guarantees the precise depth of treatment.
What are the risks and side effects of CK?
Because CK is minimally invasive and extremely precise, the procedure has exhibited very minimal risk and almost no side effects.
During the first 24 to 48 hours after CK, you may experience mild to moderate pain, discomfort, blurry vision, tearing and/or light sensitivity as the cornea heals. Initially, you may also experience slight vision fluctuation throughout the day, a noticeable over-correction of your vision, mild blurred vision and headaches as you adapt to your new vision. These symptoms should stabilize during the following weeks. We recommend that you avoid visually demanding tasks for the first couple of weeks following surgery until your vision has stabilized and you have adjusted to your new vision.
Some patients experience an induced astigmatism following their procedure. If this happens, it can be cleared up through an enhancement that often times only requires one additional spot treatment.
Because CK doesn't cut or remove tissue, many of the side effects associated with other vision treatment procedures have not been observed with CK.
During your evaluation appointment, make sure you have all of your questions answered before you make the decision to have the treatment.
Are there restrictions after having CK?
As with any vision treatment procedure where the cornea is altered, certain precautions should be taken. Patients should avoid getting contaminated water in the eyes for at least one week. This includes water from swimming pools, spas, lakes and the ocean. When showering or taking baths, the eyes should be kept closed in order to avoid getting soap and dirty water in them. When exercising, sweat should be kept out of the eyes for at least a week, and vigorous rubbing must be avoided for two weeks following the procedure. Eye makeup should be avoided for one week after surgery.
Some patients do not feel comfortable driving for the first couple of days (or weeks) following surgery as their eyes continue to heal and their vision continues to fluctuate. We recommend that you use your judgment before you get behind the wheel of an automobile, particularly when driving at night. You may want to try being a passenger first to see if you have enough visual acuity to operate a motor vehicle safely. If necessary, you may need to have a temporary pair of glasses to help you transition through the recovery process.
Am I guaranteed 20/20 vision after CK?
No surgeon can absolutely guarantee a certain result from any vision treatment procedure. At this time, nearly 95% of patients with low to moderate ranges of presbyopia achieve normal or near normal vision after CK.
Will I ever need glasses or contacts again?
The majority of patients do not need corrective lenses of any kind after the CK procedure has completed healing. However, depending on your age and the type of refractive disorder you have, you may need additional vision correction at some point. (Surgery, reading glasses or bifocals). This is because your eyes continue to change as you age, and no one can avoid presbyopia, the natural result of aging which occurs when the eye's focusing ability diminishes. CK NearVision was the first FDA approved treatment of presbyopia, however it is not a permanent solution for presbyopia as it does not stop the aging process and you may need to wear glasses or contact lenses for some activities (ie. reading without proper lighting). Even in patients who experience good near-vision following the procedure, they still need to rely on glasses for certain activities. It is unreasonable to expect this procedure to completely eliminate the need for external visual aids. Glasses may be needed for extended periods of visual straining, for reading in poor lighting, or reading very tiny print.
Can CK treat astigmatism?
The procedure is currently being studied internationally for the treatment of astigmatism and we expect to soon be able to use it for that purpose. If astigmatism is induced during treatment, an enhancement may be necessary to eliminate the astigmatism by adding one additional treatment spot. At this point, the best treatment for astigmatism is LASIK.
What will I feel after CK?
After surgery there may be mild discomfort, and many patients experience a foreign body sensation or a slight scratchiness in the eye. This usually subsides within 24 hours. You will be provided with prescriptions for a mild pain remedy and for a mild sedative to help you sleep. Studies have shown that patients who sleep a great deal in the first 24 hours tend to heal more quickly which is why we recommend that you sleep as much as possible during the initial 24 hours after your CK procedure.
Can CK treat presbyopia?
NearVision CK was the first treatment to receive FDA approval for treating presbyopia. Initially only distance vision was treated with CK, though most patients reported a dramatic improvement in near vision as well. Some patients may be treated with "blended" vision, correcting one eye for distance and the other for near vision.
Can CK treat myopia (nearsightedness)?
CK was designed only for farsightedness (hyperopia) and presbyopia, where the cornea requires steepening. Nearsightedness requires flattening the cornea and LASIK is an effective procedures to accomplish that.
Can CK treat over or under correction from LASIK or other refractive procedures?
CK is currently being studied in an international clinical trial for use in treating these cases.
Is CK reversible?
CK is not reversible. Like most other refractive procedures, once the CK is performed it is not possible to remove its effect. This is important for anyone contemplating surgery to carefully consider. To learn if CK is right for you we invite you to schedule a thorough, complimentary evaluation to discuss your correction with the surgeon.
You will find that the results of CK are not permanent. It is very possible that additional treatments will be needed in the future as the lens behind your eye continues to age and lose focusing ability.
Why did the FDA approve CK for the temporary treatment of hyperopia?
Hyperopia is a progressive condition. This means that as people age their level of farsightedness will increase-with or without surgical intervention. It is for this reason the FDA recently changed its stability guidelines defining even hyperopic LASIK as temporary on its website. Clinical data shows CK's stability is similar to hyperopic LASIK and significantly better than other refractive procedures such as LTK (laser thermal Keratoplasty). Because CK requires no cutting or removal of tissue and doesn't entail the risks associated with other procedures it is more attractive for both initial and repeated treatments.
Will my health insurance cover the cost of the CK procedure?
Because CK is considered elective surgery most insurance plans do not cover it. We offer convenient financing plans and we accept credit cards. Some employers also have Flex Spending accounts which normally may be used for procedures including CK. Be sure to check with your plan to be sure.
Who is CK right for?
CK has been approved for mild to moderate presbyopia or hyperopia, up to +2.25 diopters. Some basic criteria to be considered a good candidate include:
Be at least 40 years of age
Have had good distance vision for most of their lives
Be tired of reading glasses
No drastic change in prescription within the past year
No medical eye conditions (such as glaucoma, cataracts, keratoconus or chronic dry eyes)
No medical conditions such as diabetes, pregnancy, vascular or autoimmune diseases
Not higher than +.75 astigmatism
Do not have an implanted electrical device (ie. Pacemaker) since the CK system may interfere with these types of devices
Have realistic expectations about the outcomes
How is a precise amount of energy and depth of treatment ensured during the CK procedure?
The system we use was engineered specifically for the CK procedure. The precise amount of RF energy needed to affect the corneal tissue, at the precise tissue temperature and depth of treatment, were meticulously investigated and defined.
What is the risk of the collagen being overheated and causing scarring?
The risk of the collagen being heated above the optimal or permanent shrinkage temperature is almost nonexistent with the CK system. Comprehensive thermal modeling and long-term clinical effectiveness and stability data ensure that the system consistently and accurately reaches the appropriate temperature to induce optimal tissue shrinkage.
Can CK be performed on patients who have a pacemaker?
A. The CK equipment can produce interference that may adversely influence the operation of other electronic equipment. Therefore CK is not recommended for patients who are wearing an unshielded pacemaker. If you have a shielded pacemaker this should not be a problem.
What enables CK to be performed in-office?
CK is a minimally invasive procedure that does not require cutting of the cornea, and therefore does not carry the associated risks or surgical complications. The procedure is relatively quick and easy to perform, taking an average of just three minutes. Your CK will be performed in our outpatient surgery center in our Tacoma clinic.
How Can I find out if I am a candidate for CK?
A. If you are interested in CK vision correction, we would like to invite you to schedule an evaluation appointment with the doctor. We will do all of the tests necessary to determine if you are a candidate for CK, and the doctor will work discuss the procedure with you in terms of your specific your lifestyle needs.
It is important that you do not wear contact lenses prior to your evaluation so that we can get the most accurate test results. If you wear soft contact lenses, you must discontinue use for one week prior to the evaluation. If you wear hard contact lenses, stop using them for at least three weeks prior to your evaluation.