Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Conductive Keratoplasty Hyperopia and Presbyopia Workup

  • Author: Manolette R Roque, MD, MBA, FPAO; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Mar 15, 2016
 

Imaging Studies

Corneal topography development provides surgeons with effortlessly understood color-coded maps of corneal curvature, in addition to quantitative indexes of irregular astigmatism that correlate with potential visual acuity.[31] Modern instrumentation produces a videokeratograph (generally a color-coded contour map).[14] The use of keratography in preoperative and postoperative evaluation of all refractive surgery patients is valuable. Different manufacturers use different methods (eg, Placido, 40 scanned slits, combination Placido and 40 scanned slits, phase modified laser holography, raster stereography).

The pachymeter (eg, optical, ultrasonic) is used to measure corneal thickness. Accurate determination of corneal thickness preoperatively allows the surgeon to set the depth of incision to two thirds of the measured result. Orbscan II by Orbtek uses both 40 scanned slits and Placido methods to provide data on anterior and posterior corneal curvature and corneal thickness.

Ultrasonic biomicroscopy is used to measure corneal thickness (where available). Typically, it is used in clinical studies.

 
 
Contributor Information and Disclosures
Author

Manolette R Roque, MD, MBA, FPAO Section Chief, Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center; Section Chief, Ocular Immunology and Uveitis, International Eye Institute, St Luke's Medical Center Global City; Senior Eye Surgeon, The LASIK Surgery Clinic; Director, AMC Eye Center, Alabang Medical Center

Manolette R Roque, MD, MBA, FPAO is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Philippine Medical Association, American Uveitis Society, International Ocular Inflammation Society, Philippine Ocular Inflammation Society, American Society of Ophthalmic Administrators, American Academy of Ophthalmic Executives, Philippine Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Ruben Limbonsiong, MD 

Ruben Limbonsiong, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Roberto Pineda, II, MD Director, Refractive Surgery Service, Massachusetts Eye and Ear Infirmary; Associate Professor of Ophthalmology, Harvard Medical School

Roberto Pineda, II, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery

Disclosure: Received consulting fee from Amgen for review panel membership; Received consulting fee from Genzyme?Sanofi for review panel membership; Received consulting fee from Novartis for consulting; Received consulting fee from Beaver-Visitec for consulting.

Barbara L Roque, MD, DPBO, FPAO Senior Partner, Roque Eye Clinic; Chief of Service, Pediatric Ophthalmology and Strabismus Section, Department of Ophthalmology, Asian Hospital and Medical Center; Active Consultant Staff, International Eye Institute, St Luke's Medical Center Global City

Barbara L Roque, MD, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Philippine Society of Cataract and Refractive Surgery, Philippine Academy of Ophthalmology, Philippine Society of Pediatric Ophthalmolo

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

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, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

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, Association for Research in Vision and Ophthalmology

Disclosure: Received grant/research funds from Alcon Labs for independent contractor; Received grant/research funds from Abbott Medical Optics for independent contractor; Received ownership interest from Acufocus for consulting; Received ownership interest from WaveTec for consulting; Received grant/research funds from Topcon for independent contractor; Received grant/research funds from Avedro for independent contractor; Received grant/research funds from ReVitalVision for independent contractor.

Acknowledgements

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

References
  1. Duffey RJ, Leaming D. US trends in refractive surgery: 2003 ISRS/AAO survey. J Refract Surg. 2005 Jan-Feb. 21(1):87-91. [Medline].

  2. Duffey RJ, Leaming D. US trends in refractive surgery: 2002 ISRS survey. J Refract Surg. 2003 May-Jun. 19(3):357-63. [Medline].

  3. Duffey RJ, Leaming D. U.S. trends in refractive surgery: 2001 International Society of Refractive Surgery Survey. J Refract Surg. 2002 Mar-Apr. 18(2):185-8. [Medline].

  4. Ocular Surgery News. Laser market provides valuable options for low levels of hyperopiaRegression may be a thing of the past as developments continue in laser and laser-like procedures for hyperopia. 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  5. Waring GO 4th, Durrie DS. Emerging trends for procedure selection in contemporary refractive surgery: consecutive review of 200 cases from a single center. J Refract Surg. 2008 Apr. 24(4):S419-23. [Medline].

  6. Talley-Rostov A. Patient-centered care and refractive cataract surgery. Curr Opin Ophthalmol. 2008 Jan. 19(1):5-9. [Medline].

  7. Ditzen K, Huschka H, Pieger S. LASIK for hyperopia. Burrato L, ed. LASIK Principles and Techniques. Slack Inc; 1998. Vol 22: 269-75.

  8. Klein S, Fry K, Hersh PS. Laser in situ keratomileusis after conductive keratoplasty. J Cataract Refract Surg. 2004 Mar. 30(3):702-5. [Medline].

  9. Kymionis GD, Aslanides IM, Khoury AN, et al. Laser in situ keratomileusis for residual hyperopic astigmatism after conductive keratoplasty. J Refract Surg. 2004 May-Jun. 20(3):276-8. [Medline].

  10. Ocular Surgery News. Thermal keratoplasty techniques face off at ISRS meeting. Top doctors discussed the pros and cons of three thermal keratoplasty techniques for hyperopia. 2002. Available at: http://www.osnsupersite.com/. [Full Text].

  11. Fernandez-Suntay JP, Pineda R 2nd, Azar DT. Conductive keratoplasty. Int Ophthalmol Clin. 2004 Winter. 44(1):161-8. [Medline].

  12. Haw WW, Manche EE. Conductive keratoplasty and laser thermal keratoplasty. Int Ophthalmol Clin. 2002. 42(4):99-106. [Medline].

  13. Huang B. Update on nonexcimer laser refractive surgery technique: conductive keratoplasty. Curr Opin Ophthalmol. 2003 Aug. 14(4):203-6. [Medline].

  14. Rojas MC, Manche EE. Comparison of videokeratographic functional optical zones in conductive keratoplasty and laser in situ keratomileusis for hyperopia. J Refract Surg. 2003 May-Jun. 19(3):333-7. [Medline].

  15. Asbell PA, Maloney RK, Davidorf J, et al. Conductive keratoplasty for the correction of hyperopia. Trans Am Ophthalmol Soc. 2001. 99:79-84; discussion 84-7. [Medline].

  16. Dawson DG, Edelhauser HF, Grossniklaus HE. Long-term histopathologic findings in human corneal wounds after refractive surgical procedures. Am J Ophthalmol. 2005 Jan. 139(1):168-78. [Medline].

  17. Wang TJ, Lo W, Hsueh CM, et al. Ex vivo multiphoton analysis of rabbit corneal wound healing following conductive keratoplasty. J Biomed Opt. 2008 May-Jun. 13(3):034019. [Medline].

  18. McDonald M, Hersh P. A Prospective Multicenter Clinical Trial to Evaluate the Safety and Effectiveness of the ViewPoint CK System for the Correction of Hyperopia Utilizing the Conductive Keratoplasty (CK) Procedure. FDA Protocol RCS-001-HYP. 2001. Available at: http://www.fda.gov/ohrms/dockets/ac/01/briefing/3806b1_05_sponsor. [Full Text].

  19. McDonald MB, Durrie D, Asbell P, et al. Treatment of presbyopia with conductive keratoplasty: six-month results of the 1-year United States FDA clinical trial. Cornea. 2004 Oct. 23(7):661-8. [Medline].

  20. Berjano EJ, Alio JL, Saiz J. Modeling for radio-frequency conductive keratoplasty: implications for the maximum temperature reached in the cornea. Physiol Meas. 2005 Jun. 26(3):157-72. [Medline].

  21. Choi B, Kim J, Welch AJ, et al. Dynamic impedance measurements during radio-frequency heating of cornea. IEEE Trans Biomed Eng. 2002 Dec. 49(12 Pt 2):1610-6. [Medline].

  22. Kornmehl EW. FDA approves help for aging eyes. Conductive keratoplasty may improve vision for people older than 40 who need reading glasses to see "the fine print". Health News. 2004 Jun. 10(6):8-9. [Medline].

  23. Hersh PS. Optics of conductive keratoplasty: implications for presbyopia management. Trans Am Ophthalmol Soc. 2005. 103:412-56. [Medline].

  24. Sy ME, Kovoor TA, Tannan A, Choi D, Deng SX, Danesh J, et al. Combined astigmatic keratotomy and conductive keratoplasty to correct high corneal astigmatism. J Cataract Refract Surg. 2015 May. 41 (5):1050-6. [Medline].

  25. Alio JL, Claramonte PJ, Caliz A, et al. Corneal modeling of keratoconus by conductive keratoplasty. J Cataract Refract Surg. 2005 Jan. 31(1):190-7. [Medline].

  26. Comaish IF, Lawless MA. Conductive keratoplasty to correct residual hyperopia after corneal surgery. J Cataract Refract Surg. 2003 Jan. 29(1):202-6. [Medline].

  27. Hersh PS, Fry KL, Chandrashekhar R, et al. Conductive keratoplasty to treat complications of LASIK and photorefractive keratectomy. Ophthalmology. 2005 Nov. 112(11):1941-7. [Medline].

  28. Ehrlich JS, Manche EE. Regression of effect over long-term follow-up of conductive keratoplasty to correct mild to moderate hyperopia. J Cataract Refract Surg. 2009 Sep. 35 (9):1591-6. [Medline].

  29. Esquenazi S, He J, Kim DB, Bazan NG, Bui V, Bazan HE. Wound-healing response and refractive regression after conductive keratoplasty. J Cataract Refract Surg. 2006 Mar. 32 (3):480-6. [Medline].

  30. Moshirfar M, Anderson E, Hsu M, Armenia JM, Mifflin MD. Comparing the rate of regression after conductive keratoplasty with or without prior laser-assisted in situ keratomileusis or photorefractive keratectomy. Middle East Afr J Ophthalmol. 2012 Oct. 19 (4):377-81. [Medline].

  31. Smolek MK, Klyce SD. Zernike polynomial fitting fails to represent all visually significant corneal aberrations. Invest Ophthalmol Vis Sci. 2003 Nov. 44(11):4676-81. [Medline].

  32. Du TT, Fan VC, Asbell PA. Conductive keratoplasty. Curr Opin Ophthalmol. 2007 Jul. 18(4):334-7. [Medline].

  33. McDonald MB. Conductive keratoplasty: a radiofrequency-based technique for the correction of hyperopia. Trans Am Ophthalmol Soc. 2005. 103:512-36. [Medline].

  34. McDonald MB, Hersh PS, Manche EE, et al. Conductive keratoplasty for the correction of low to moderate hyperopia: U.S. clinical trial 1-year results on 355 eyes. Ophthalmology. 2002 Nov. 109(11):1978-89; discussion 1989-90. [Medline].

  35. Haji SA, Ramonas K, Potapova N, et al. Intraoperative correction of induced astigmatism after spherical correction of hyperopia with conductive keratoplasty. Eye Contact Lens. 2005 Mar. 31(2):76-9. [Medline].

  36. McDonald MB, Davidorf J, Maloney RK, et al. Conductive keratoplasty for the correction of low to moderate hyperopia: 1-year results on the first 54 eyes. Ophthalmology. 2002 Apr. 109(4):637-49; discussion 649-50. [Medline].

  37. Khalifa YM, Mifflin MD. Keratitis and corneal melt with ketorolac tromethamine after conductive keratoplasty. Cornea. 2011 Apr. 30(4):477-8. [Medline].

  38. Khalifa YM, Mifflin MD. Keratitis and corneal melt with ketorolac tromethamine after conductive keratoplasty. Cornea. 2011 Apr. 30(4):477-8. [Medline].

  39. Kymionis GD, Naoumidi TL, Aslanides IM, et al. Corneal iron ring after conductive keratoplasty. Am J Ophthalmol. 2003 Aug. 136(2):378-9. [Medline].

  40. Kymionis GD, Titze P, Markomanolakis MM, et al. Corneal perforation after conductive keratoplasty with previous refractive surgery. J Cataract Refract Surg. 2003 Dec. 29(12):2452-4. [Medline].

  41. Ou JI, Manche EE. Corneal perforation after conductive keratoplasty in a patient with previously undiagnosed Sjögren syndrome. Arch Ophthalmol. 2007 Aug. 125(8):1131-2. [Medline].

  42. Kymionis GD, Naoumidi TL, Aslanides IM, et al. Intraocular pressure measurements after conductive keratoplasty. J Refract Surg. 2005 Mar-Apr. 21(2):171-5. [Medline].

  43. Moshirfar M, Feilmeier M, Kumar R. Anterior chamber inflammation induced by conductive keratoplasty. J Cataract Refract Surg. 2005 Aug. 31(8):1676-7. [Medline].

  44. McDonald M, Durrie D, Maloney R, et al. Breakfast with the Experts. ViewPoint Conductive Keratoplasty. American Academy of Ophthalmology. 2001.

  45. McDonald M. Conductive keratoplasty for the correction of low to moderate hyperopia: one-year results on the first 54 eyes. Ophthalmology. 2002 Sep. 109(9):1583. [Medline].

  46. Nataloni R. Conductive keratoplasty offers hyperopes a non-laser option. One-year results suggest the radiofrequency technique provides postoperative stability for hyperopes. Ocular Surgery News Europe/Asia Pacific Edition. 2000. Available at: http://www.osnsupersite.com/. [Full Text].

  47. Nataloni R. Conductive keratoplasty likened to LASIK in phase 3 study. Radio-frequency collagen shrinkage procedure offers predictability and spares the visual axis. Ocular Surgery News. February 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  48. Ocular Surgery News. ViewPoint CK System begins US phase 3 trial. 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  49. Ocular Surgery News. FDA panel says CK is approvable for temporary reduction of hyperopiaTwelve-month analysis of 171 eyes showed that the procedure easily beat the FDA guidelines by showing that 91% of patients were corrected to 20/40 or better. 2002. Available at: http://www.osnsupersite.com/. [Full Text].

  50. Ocular Surgery News. FDA panel gives CK "approvable" recommendation. 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  51. Ocular Surgery News. Conductive keratoplasty using ViewPoint CK system is safe, highly effective, study says. Today's Top Story and Breaking News feature highlights from yesterday's American Academy of Ophthalmology presentations. 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  52. Ocular Surgery News. CK shows better efficacy than hyperopic LASIK, speakers say. 2001. Available at: http://www.osnsupersite.com/. [Full Text].

  53. Haji SA, Brocks DC, Fahim MM, et al. Videokeratography in conductive keratoplasty. J Refract Surg. 2004 Jul-Aug. 20(4):329-36. [Medline].

  54. Asbell PA, Maloney R, Davidorf J, et al. Stability of hyperopic correction with conductive keratoplasty (CK). Invest Ophthalmol Vis Sci. 2001. 42(4 Suppl):S900.

  55. Moshirfar M, Anderson E, Hsu M, Armenia JM, Mifflin MD. Comparing the rate of regression after conductive keratoplasty with or without prior laser-assisted in situ keratomileusis or photorefractive keratectomy. Middle East Afr J Ophthalmol. 2012 Oct. 19(4):377-81. [Medline]. [Full Text].

  56. Tomita M, Watabe M, Ito M, Tsuru T. Conductive keratoplasty for the treatment of presbyopia: comparative study between post- and non-LASIK eyes. Clin Ophthalmol. 2011. 5:231-7. [Medline]. [Full Text].

  57. Habibollahi A, Hashemi H, Mehravaran S, Khabazkhoob M. Visual Outcomes of Conductive Keratoplasty to Treat Hyperopia and Astigmatism After Laser in situ Keratomileusis and Photorefractive Keratectomy. Middle East Afr J Ophthalmol. 2011 Jul. 18(3):238-42. [Medline]. [Full Text].

  58. Tomita M, Watabe M, Ito M, Tsuru T. Conductive keratoplasty for the treatment of presbyopia: comparative study between post- and non-LASIK eyes. Clin Ophthalmol. 2011. 5:231-7. [Medline]. [Full Text].

  59. Kato N, Toda I, Kawakita T, Sakai C, Tsubota K. Topography-guided conductive keratoplasty: treatment for advanced keratoconus. Am J Ophthalmol. 2010 Oct. 150(4):481-489.e1. [Medline].

  60. Basu S, Sangwan VS. Efficacy and safety of conductive keratoplasty in keratoconus. Am J Ophthalmol. 2011 Apr. 151(4):735; author reply 735-6. [Medline].

  61. Pallikaris IG, Naoumidi TL, Astyrakakis NI. Conductive keratoplasty to correct hyperopic astigmatism. J Refract Surg. 2003 Jul-Aug. 19(4):425-32. [Medline].

  62. Sokol JA, Tammaro YR, Haji SA, et al. Conductive keratoplasty and the coupling phenomenon. Eye Contact Lens. 2005 May. 31(3):111-6. [Medline].

  63. Ardjomand N, Wohlfart C, McAlister JC, et al. Conductive keratoplasty for asymmetric corneal astigmatism. J Cataract Refract Surg. 2008 May. 34(5):874-5. [Medline].

  64. Anonymous. Conductive keratoplasty (CK) for presbyopia. Med Lett Drugs Ther. 2004 Jun 21. 46(1185):49-50. [Medline].

  65. Claramonte PJ, Alio JL, Ramzy MI. Conductive keratoplasty to correct residual hyperopia after cataract surgery. J Cataract Refract Surg. 2006 Sep. 32(9):1445-51. [Medline].

  66. Lin DY, Manche EE. Two-year results of conductive keratoplasty for the correction of low to moderate hyperopia. J Cataract Refract Surg. 2003 Dec. 29(12):2339-50. [Medline].

  67. Pallikaris G, Naoumidi TL, Panagopoulou SI, et al. Conductive keratoplasty for low to moderate hyperopia: 1-year results. J Refract Surg. 2003 Sep-Oct. 19(5):496-506. [Medline].

  68. Pallikaris IG, Naoumidi TL, Astyrakakis NI. Long-term results of conductive keratoplasty for low to moderate hyperopia. J Cataract Refract Surg. 2005 Aug. 31(8):1520-9. [Medline].

  69. Panescu D. Conductive keratoplasty. IEEE Eng Med Biol Mag. 2004 Jul-Aug. 23(4):16-8. [Medline].

  70. Quinto GG, Camacho W, Behrens A. Postrefractive surgery dry eye. Curr Opin Ophthalmol. 2008 Jul. 19(4):335-41. [Medline].

  71. Stahl JE. Conductive keratoplasty for presbyopia: 3-year results. J Refract Surg. 2007 Nov. 23(9):905-10. [Medline].

  72. Ye PP, Xu W, Xu HS, Li ZC, Shi JT, He FY, et al. Conductive keratoplasty: an approach for the correction of residual hyperopia in post-lasik pseudophakia. Int J Ophthalmol. 2012. 5(5):630-3. [Medline]. [Full Text].

Previous
Next
 
ViewPoint conductive keratoplasty device. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. Speculums. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. Suture. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. Corneal markings. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. ViewPoint with radiation. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. Change in corneal curvature. Published with permission from Refractec.
Hyperopia, conductive keratoplasty. Refractec, 1 hour. Published with permission from Refractec.
Video introduction to conductive keratoplasty.
Conductive keratoplasty conventional pressure technique.
NearVision conductive keratoplasty with LightTouch technique.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.