Eye Surgery Without Laser

Britain's Queen Elizabeth II, right, accompanied by her grandsons, Prince William, left, and Prince Harry, center, stand on the main balcony of Buckingham Palace while attending the annual Trooping the Color in central London on Saturday, June 13, 2009. The Queen celebrated her official birthday Saturday with the Trooping the Color parade involving more than 1,000 soldiers in the traditional display of pomp and pageantry.
AP Photo/Lefteris Pitarakis
Farsightedness affects about 60 million people in the U.S. The Food and Drug Administration (FDA) has just approved a new procedure that can correct the problem without a laser. Dr. Emily Senay reports for HealthWatch.

It's called Conductive Keratoplasty -- C. K., for short -- and it has been approved for use in correcting mild to moderate hyperopia, or farsightedness. That's a condition where a person has good distance vision but has trouble reading and focusing up close. Laser surgery can be used to correct the problem, but it's not as easy to fix with a laser as short-sightedness. This new procedure provides an alternative to lasik, using the heat generated from radio frequency energy to fix the problem.
A probe that releases R.F. energy is used to apply heat to points in a circle on the surface of the eye around the edge of the cornea. The heat shrinks and tightens the collagen in the eye and pulls it tighter like a belt, increasing the curvature of the eye over the cornea to correct the farsightedness.

C.K. is a quick and easy outpatient procedure. It takes about three minutes and most patients can see results right away. Most are able to return to work the next day.

Procedure comparison with laser surgery

Patient satisfaction in clinical trials was very high with C.K., and most doctors agree the potential risks are less than lasik because the procedure is less invasive. Lasik involves cutting the eye to make a flap and then removing tissue with the laser, whereas C.K. does not. Lasik surgery has good results in the majority of patients, but there can be problems. It is not uncommon to have side effects like sensations of dryness or glare from brighter lights, and in rare cases scarring has caused some vision loss.

Risks or side effects

So far C.K. appears to be effective and safe, with minor irritation for a day or so following the procedure. And of the 344 patients in the trials, 92 percent can now see 20/40 or better. The vision level required for a driver license, and 56 percent of patients can see 20/20 or better.

These good results have lasted up to two years in the first patients to receive the treatment, but doctors will need to follow patients over the long term to see how long the results last. A similar procedure using a laser to shrink the tissue did not provide permanent results.

C.K. is not suitable for severe farsightedness, only mild to moderate cases. A typical person with moderate farsightedness is in their late thirties or forties, has never worn glasses but is starting to have trouble reading. Many farsighted people are not diagnosed until they get older, because they are able to make their eyes work harder to make up for their farsightedness.

Currently, there are studies underway to see if it works for presbyopia, which is the loss of flexibility in the lens of the eye as a person ages, and also for astigmatism, which distorts vision.

Insurance coverage

Vision correction is considered an elective surgery by insurance companies and is not covered. It is available as of April 17 across the country in forty-three sites around the country. The cost is variable from doctor to doctor and is comparable to lasik surgery, which is around one thousand to two thousand dollars per eye.