Successful LASIK after RK: Factors to Consider

RK or also known as Radial keratotomy is a surgical procedure performed to correct myopia and myopic astigmatism in the 1980s. The purpose of RK is to shift the cornea's focus back onto the retina by reducing the central corneal curvature through tiny cuts at the edge of the cornea. However, this procedure is not precise resulting in under or overcorrection of patients' vision. Due to this reason, many patients are considering to undergo another eye surgery, such as LASIK surgery.

It is usually possible for RK patients to have LASIK or other refractive surgeries but the success rate will depend on a few factors.

Fluctuation of weakened corneas of RK patients make it difficult for glasses fitting. Unstable corneas are also not suitable to undergo second eye surgery. It is important to check the cornea stability before deciding on another cornea surgery.

Hyperopic shift is also a difficulty for RK patients. RK patients who were previously treated for myopia are becoming farsighted because of the shifting of the weakening cornea.

Presbyopia is a common vision problem suffered by patients who achieve the age of 40. However, there are currently no safe and reliable ways to cure this problem with additional eye surgery. If the patient has both hyperopia and presbyopia, he may consider correcting his hyperopia provided the cornea is relatively stable.

Corneal irregularities will resulted in irregular astigmatism for patients with previous RK. It may be quite difficult to perfectly correct this problem, but it can be improved with various LASIK surgeries. However, Wavefront-guided ablation may be impossible if the irregularities are too great.

Advance Surface Ablation (ASA) techniques like PRK or LASEK is more suitable for RK patients. Since RK makes deep radial incisions into the cornea, there might be risk where the cornea fall into pieces when the cornea flap is created in LASIK. Intacs is also a good choice as it could stabilize a fluctuating cornea. Although Epi-Lasik is also an ASA technique, it could not be safely performed on RK patients.

Lens Based Surgeries such as RLE or P-IOL are better alternatives to resolve some refractive errors for RK patients whose corneas are weak. However, these techniques do not overcome the corneal fluctuation problems.

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