THE NearVisionCK PROCEDURE
Conductive Keratoplasty (CK) was introduced and approved by the FDA in the US in 2002 for the treatment of hyperopia. It was approved by the FDA in the US for the treatment of presbyopia in 2004. CK is not a laser. It utilizes a controlled release of radiofrequency (RF) energy to cause shrinkage of the collagen tissues in the outer cornea which results in a tightening of the peripheral cornea. This causes a steepening of the central corneal curvature and a reduction in hyperopia. A very thin corneal probe with a cool tip about the size and thickness of a human hair is inserted into the peripheral cornea and the radiofrequency energy is released from the probe tip. A plastic guard on the tip controls the proper depth and safety, and allows for a well controlled uniform amount of energy release. This results in a very predictable amount of tissue shrinkage and a repeatable amount of corneal steepening. Each energy release creates a small localized round shrinkage "spot" called a leucoma in the cornea. By placing these spots in a ring around the visual axis, the corneal curvature is affected in a controlled predictable manner. The eye is never entered; treatment is only applied to the surface structures. The amount of correction needed varies for each individual and is achieved by increasing the number of spots and by changing the location and diameter of the ring of spots. Radiofrequency energy is safe and proven; doctors have been safely using this technology in surgery since the 1950s.
NearVisionCK is usually performed on one eye only for most patients. Usually the non-dominant eye as determined at the evaluation is chosen for treatment. The procedure results in what has been called a "blended" vision whereby the treated eye has better vision for near but retains functional distance vision also in conjunction with the untreated dominant eye. Those patients who need some improvement in distance vision in the dominant eye will do better with treatment in both eyes, less on the dominant eye to improve distance only and more treatment on the non-dominant eye for near. This technique should not be confused with MONOVISION which can be achieved with contact lenses, LASIK or cataract surgery with monofocal implants. Monovision creates distance vision in the dominant eye and near vision in the non-dominant eye, but the difference is that there is no retention of distance vision in the near eye; that is, no blended vision and no retention of any distance component. There is a much more marked disparity in the vision between the two eyes in monovision as compared to NearVisionCK.
During the evaluation exam for NearVisionCK, Dr. Jaben performs a simulation of the blended vision which one can achieve with the NearVisionCK procedure. This is referred to as the LOOSE LENS TEST and allows the patient to experience a similar representation while trying to decide about having the procedure.
The NearVisionCK evaluation exam is essentially a complete general eye exam performed at the offices of Charlotte Eye Ear Nose and Throat Asssociates which allows Dr. Jaben to assess the overall eye health and whether a patient is a candidate. The LOOSE LENS TEST is performed at this exam. If it is determined that you are a good candidate, there is one additional screening exam and a preoperative discussion at no additional charge. These are needed to gain and share other important information about the eyes and the procedure such as complications, expectations, and restrictions. The additional screening exam as well as the procedure are performed at TLC Laser Eye Center where Dr. Jaben is a Medical Director.
The only preoperative preparation is the use of antibiotic eye drops. On the day of the procedure at the laser center, full instructions and restrictions will be given and other eye medications provided. The procedure takes about 5 minutes per eye. Before the procedure, patients are given anesthetic eye drops to numb the eye and there is usually no pain experienced during the procedure or after. An instrument called a lid speculum is inserted to hold open the eyelids during the procedure. Vision improvement is usually noted immediately after the procedure. The patient should plan to return home after the procedure and then to work and normal activities the following day. The first office postoperative exam is usually in one week at Dr. Jaben's office at Charlotte EENT Associates. Patients should expect a period of neural adaptation to the new vision system that may require 90 days as well as foreign body sensation, fluctuating vision, light sensitivity, glare at night, imbalanced vision and variability in reading vision distances early in the postoperative course. Vision does not recover as quickly as with LASIK procedures. Complications are very unusual. It is very rare to experience an infection or other serious problem. About 10% of patients will need a second enhancing procedure early in the postoperative period within 1 to 4 months after surgery for either undercorrection or induced astigmatism (see NearVisionCK fee schedule for information).
NearVisionCK is a minimally invasive procedure with little risk which has been designed to return "vision for daily life." You are likely to be a good candidate for NearVisionCK if (1) you are 45 years of age or older, (2) you have had good distance vision without glasses or contact lenses, and (3) you are tired of reading glasses and are interested in eliminating or reducing your dependency on reading glasses for near vision. If this is you, then follow the instructions on this website for contacting Dr. Scott Jaben for a NearVisionCK evaluation.
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