GVR Scleral Lens and RK

Radial Keratotomy (RK) was the first refractive surgical procedure introduced into the United States. Millions of patients around the world underwent this needless and harmful procedure in the 1980's and 1990's. Over two million procedures were done in the United States and Canada alone. In addition, over a million LASIK procedures were later done to these same patients in an attempt to undo the damage done by the initial RK surgeries. The end result of these multiple refractive surgical procedures was millions of permanently damaged eyes requiring either corneal transplant surgery or the use of specialty contact or scleral lenses.

Radial Keratotomy involved the making of small deep slices into the cornea (the front surface of the eye) in an attempt to reduce nearsightedness (myopia) and astigmatism. The long term results of RK were complications that were so horrific that many of these patients were unable to function visually either with eyeglasses or contact lenses. In addition to the reduced vision, most of these hurt patients experienced significant ocular discomfort and pain. Many complications occurred years after the surgeries were done. These complications include:

  • 1. Loss of best corrected visual acuity.
  • 2. Double or triple vision.
  • 3. Irregular corneal curvatures.
  • 4. Unstable or fluctuating vision.
  • 5. Severe dry eye.
  • 6. Halos, glare and reduced indoor and night vision.
  • 7. Permanently open incisions.
  • 8. Recurrent ocular infections and inflammation.
  • 9 Severe depression and in some cases thoughts of suicide.

Over the years our specialty practice has treated thousands of RK patients who also underwent additional RK procedures followed by one or more LASIK procedures. In every instance, the additional surgical procedures only made matters worse. Many of these patients (less than 5%) eventually needed to undergo corneal transplant surgery.

In recent years advancements in scleral lens technology have allowed the great majority of this hurt patient population to see clearly and comfortably once again. Virtually every hurt post-RK/ post-LASIK patient who were fit with the GVR Scleral lens experienced a dramatic improvement in their visual acuity and ocular comfort.

The GVR Scleral lens is unique in that this lens vaults over the compromised cornea and rests on the white portion of the eye known as the sclera. Sterile unpreserved saline solution fills the space between the back surface of the lens and the front surface of the cornea. Comfort and vision are almost always excellent. In addition, the dryness (scratchy and itchy) issues that so many post-refractive surgical patients experience are for the most part gone. In other words, the GVR Scleral lens has a therapeutic effect of the damaged eye. It is not unusual for a post-RK patient to comment to us after having received their GVR Scleral lenses that they now have their life back.

An Example: This eye underwent R-K surgery in 1988. LASIK was performed in 2002. Shortly thereafter, post-LASIK ectasia developed. The R-K incisions are still open. A dye was instilled onto the corneal surface. You can tell that the incisions are still open because the dye can be seen within the incisions. The green-yellow circular line going around the periphery of the cornea is the LASIK flap. We fit this eye with a GVR Scleral lens in 2007 which has provided this eye with clear stable vision ever since.

The Wavefront Scleral Lens

The corneal irregularities created by refractive surgeries, such as LASIK and RK, are responsible for ghosting, halos, starbursting, and loss of contrast sensitivity. These "higher order aberrations" may exist on both the anterior and posterior. With aberrometry, the defects of the entire optical system can now be corrected by a scleral lens.

The Wavefront Scleral Lens

Autologous Serum for Dry Eyes

Dry eye conditions are among the most challenging conditions faced by refractive surgery patients. With autologous serum, blood is spun down to plasma, forming an eye drop that helps rehabilitate the cornea.

Learn More about Autologous Serum

Dr. Boshnick on CBS This Morning

See Dr. Boshnick and Dr. Morris Waxler (former FDA chief research scientist on refractive surgery) talk about bad LASIK

Optimum Infinite Gas Permeable Material

I am happy to announce that our Global Vision Rehabilitation Center will be designing and fitting all of our “high need” patients with the Optimum Infinite gas permeable contact lens material. The Optimum Infinite material is the most oxygen permeable material ever to be approved by the FDA. In addition, this newly FDA approved material includes a UV lens blocker. Now for the first time, with certain patients, wearing a scleral lens made with the Infinite material under extended wear conditions can be considered.

SMAP 3D Scleral Lens Design

NEW: Powerpoint presentation on SMAP 3D

Last year we introduced an exciting piece of technology that has allowed us to custom design a scleral lens much more accurately. It is the SMAP 3D, which is a computer attached to a dedicated camera that allows us to obtain a 3 dimensional image of the entire front surface of the eye, including the cornea and the surrounding white portion of the eye (the sclera). Up until now there has not been any technology that would allow us to measure the ocular curvatures outside the cornea. The SMAP allows us to do this. Read More

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Blurred Vision, Burning Eyes: This Is a Lasik Success?

EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

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