RADIAL KERATOTOMY USING CREATE PROTOCOL

RADIAL KERATOTOMY (RK/AK) CORNEAL REPAIR UTILIZING THE CREATE PROTOCOL

Radial Keratotomy was performed before laser vision correction, achieving the correction of myopia by cutting radial slices in the cornea with a diamond knife. The slices collapse the center of the cornea to achieve a refractive effect. These cuts are surgeon-made using an ink marker template and are 90% of the thickness of the cornea.

Each corneal incision is handmade, making each incision different in length and depth. Therefore, every RK and AK incision has its own refractive effect. Since it’s virtually impossible to make a perfect set of incisions, the combined effect creates a complex set of corneal irregularities. The extent of visual distortion and visual symptoms is based on the combined irregularity caused by each incision and how far from ideal it is in placement, length, and depth.

Many patients state that their vision was far better for several years after the initial RK/AK procedure but worsened as they aged. Old medical records are rarely available. Even when they are, it took time to understand why the vision worsened over time as imaging technology was unsophisticated and improperly utilized. Since the irregularity in the cornea is present from the moment of incision, researchers can logically attribute the visual change to epithelial compensation of corneal irregularity or to a decreased ability for the brain’s optical centers to compensate for the distorted vision.

Topographic-guided ablation with the patented CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced) made it possible to dramatically improve the irregular shape of an eye with RK and AK procedures. This procedure utilizes the patented LYRA and San Diego Protocols and the reduction of the irregularity masked by the epithelium (which standard topographic guided analysis cannot detect) to create as close to a virtually uniform cornea as possible. This can dramatically decrease visual symptoms such as ghosting, double and triple images, glare, halos, and other visual symptoms. It can also, in many cases, increase the quantity of vision as less light gets scattered.

The procedure is in two phases. Phase 1 treats the corneal irregularity and makes a more uniform cornea by repairing abnormalities. Epithelial compensation masks the irregularity, which topography-guided ablation cannot measure. The U.S. Patent Office granted Dr. Motwani a patent for this laser procedure.

The procedure will create a powerful cornea by making incisions in the original RK, which usually ends up hyperopic. Phase 2, which typically occurs four months later, corrects the power of the cornea, resulting in a full correction. In the interim healing period, the patient can wear simple glasses or contacts to treat the refractive error. They’ll have significantly decreased visual symptoms as the cornea is a much more ideal shape.

This procedure has successfully treated severe RK/AK irregularities and corneas with many incisions.

Since it is a surface procedure, healing takes 3-5 days after each phase with a bandage contact lens. In between stages, patients can get glasses in 1-2 weeks to aid with vision and return to work. If patients have significant cataract formation, we recommend they get cataract surgery two weeks after Phase 1, so their doctor can correct any residual refractive error in Phase 2.

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https://www.dovepress.com/a-protocol-for-topographic-guided-corneal-repair-utilizing-the-us-food-peer-reviewed-fulltext-article-OPTH

https://www.dovepress.com/the-use–of-wavelightr-contoura-to-create-a-uniform-cornea-the-lyra-peer-reviewed-fulltext-article-OPTH

https://www.dovepress.com/the-use-of-wavelightreg-contoura-to-create-a-uniform-cornea-the-lyra-p-peer-reviewed-fulltext-article-OPTH

https://www.dovepress.com/the-use-of-wavelightr-contoura-to-create-a-uniform-cornea-the-lyra-pro-peer-reviewed-fulltext-article-OPTH

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