eMedicine Specialties > Ophthalmology > Refractive Disorders

Hyperopia and Presbyopia, Conductive Keratoplasty: Follow-up

Author: Manolette R Roque, MD, MBA, President and CEO, Service Chief of Ocular Immunology and Uveitis, Refractive Surgery, EYE REPUBLIC Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines; Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center; Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, St. Luke's Medical Center Global City; Senior Eye Surgeon, The LASIK Surgery Clinic
Coauthor(s): Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, Eye Republic Ophthalmology Clinic; Ruben Limbonsiong, MD, Chief of Service, Refractive Surgery Service and Vision Laser Center, St. Luke's Medical Center; Program Director, Clinical Assistant Professor, Department of Ophthalmology, University of the Philippines at Manila; Roberto Pineda II, MD,, Scholar, The Academy at Harvard Medical School; Director, Refractive Surgery Service, Massachusetts Eye and Ear Infirmary; Assistant Professor of Ophthalmology, Harvard Medical School
Contributor Information and Disclosures

Updated: Oct 24, 2008

Outcome and Prognosis

In 2001, McDonald and Maloney presented the interim results of the FDA Phase III clinical trial during the American Society of Cataract and Refractive Surgery (ASCRS) meeting in San Diego. Maloney reported that at 9-month follow-up, the UCVA was found to be 20/20 or better in 60% of the eyes treated and 20/40 or better in 96% of the eyes treated. In addition, 60% of the eyes were within 0.5 D of planned correction, whereas 80% of the eyes were within 1 D of planned correction. Maloney reported the absence of adverse events or complications after 9 months. McDonald reported that at 12-month follow-up, the UCVA was found to be 20/20 for 51% of the eyes treated, 20/25 for 73% of the eyes treated, and 20/40 or better for 91% of the eyes treated.18,38,39,19,30,32,15,40,41,42,43,44,45,46

  • Presentation of results
    • Effectiveness was reported for eyes treated with current nomogram.
    • Safety and stability were reported for all eyes treated.
  • Effectiveness parameters47
    • Improvement in UCVA
      • UCVA 20/40 or better in greater than or equal to 85% of the eyes with preoperative BSCVA 20/20 or better
      • Postoperative UCVA equal to or better than preoperative BSCVA for 32% of the eyes
      • Postoperative UCVA within 1 line of preoperative BSCVA for 63% of the eyes
    • Predictability
      • MRSE within ±0.50 D for 50% of the eyes
      • MRSE within ±1.00 D for 75% of the eyes
    • Stability48
    • Patient satisfaction

In 2004, McDonald, Durrie, Asbell, et al, published the 6-month results of a 1-year clinical trial evaluating CK for the treatment of presbyopic symptoms in emmetropic and hyperopic eyes.19

  • Presentation of results
    • Of the eyes treated for near, 77% had uncorrected near vision of J3 or better at 6 months postoperatively.
    • A total of 85% of all patients had binocular distance UCVA of 20/25 or better along with J3 or better near, a combination that represents functional acuity for a presbyope.
    • Of eyes treated for near, 66% had the MRSE within ±0.50 D of intended at 6 months.
    • In 89% of eyes, the MRSE changed 0.05 D or less between 3 and 6 months postoperatively. After month 1, the incidence of variables associated with safety was 1% or lower.
    • Of patients treated, 76% were very satisfied or satisfied with their procedure.

Future and Controversies

Studies are still underway for the safe application of CK for astigmatism.31,49,50,51 Other surgical methods for the correction of hyperopia include phakic intraocular lenses (implantable contact lenses). Bifocal intraocular lenses and scleral-relaxing incision with collagen plug implantation are among the other surgical methods for the correction of presbyopia.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.



More on Hyperopia and Presbyopia, Conductive Keratoplasty

Overview: Hyperopia and Presbyopia, Conductive Keratoplasty
Workup: Hyperopia and Presbyopia, Conductive Keratoplasty
Treatment: Hyperopia and Presbyopia, Conductive Keratoplasty
Follow-up: Hyperopia and Presbyopia, Conductive Keratoplasty
Multimedia: Hyperopia and Presbyopia, Conductive Keratoplasty
References
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Further Reading

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Keywords

radiofrequency keratoplasty, CK, Refractec, farsightedness, laser surgical procedures, refractive surgery, corneal reshaping, laser in situ keratomileusis, LASIK, hyperopic LASIK, excimer laser ablation, photorefractive keratoplasty, PRK, radial keratotomy, RK, hyperopic photorefractive keratectomy, HPRK, laser thermal keratoplasty, LTK, hyperopic correction via LTK, ViewPoint conductive keratoplasty system, vision correction, NearVision CK, Light Touch, LightTouch

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Contributor Information and Disclosures

Author

Manolette R Roque, MD, MBA, President and CEO, Service Chief of Ocular Immunology and Uveitis, Refractive Surgery, EYE REPUBLIC Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines; Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center; Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, St. Luke's Medical Center Global City; Senior Eye Surgeon, The LASIK Surgery Clinic
Manolette R Roque, MD, MBA is a member of the following medical societies: American Academy of Ophthalmic Executives, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, Eye Republic Ophthalmology Clinic
Disclosure: Nothing to disclose.

Ruben Limbonsiong, MD, Chief of Service, Refractive Surgery Service and Vision Laser Center, St. Luke's Medical Center; Program Director, Clinical Assistant Professor, Department of Ophthalmology, University of the Philippines at Manila
Ruben Limbonsiong, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Roberto Pineda II, MD,, Scholar, The Academy at Harvard Medical School; Director, Refractive Surgery Service, Massachusetts Eye and Ear Infirmary; Assistant Professor of Ophthalmology, Harvard Medical School
Roberto Pineda II, MD, is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Daniel S Durrie, MD, Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center
Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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