A new wave in vision correction: Conductive Keratoplasty
May 23, 2002

By JOHN BRILEY
Special to the Washington Post

A treatment for farsightedness that uses radio waves to reshape the surface of the eye was approved by the Food and Drug Administration earlier this month. While the procedure appears to improve close vision with few side effects, it has not been studied long-term and its benefits are not permanent.

Conductive keratoplasty (known as CK) employs radio-frequency-generated heat — delivered via a follicle-thin needle — to shrink tissue along the periphery of the cornea and reshape the eye.

But CK will not help the large majority of adults who need reading glasses due to presbyopia, which is the result of loss of flexibility in the eye’s lens due to aging. By around 50, nearly all adults become presbyopic; only about 20 percent of adults have the farsighted condition that CK can treat. It usually appears around 40.

While supporters cite fewer risks of CK — since it treats the periphery of the eye, not the center, as the laser surgery technique known as Lasik does — not everyone is embracing the new procedure.

“It is much too early to line up for this procedure,” said Barrett Katz, professor and chairman of the Department of Ophthalmology at George Washington University Medical Center. “Like all currently available methods for changing the curvature of the cornea, (CK) is not riskless. It is not like getting your shoes shined.”

Katz cites the lack of long-term clinical data. “You can’t just take a few months of data and say, ’This works,’ ” Katz said. “You need to look at it 15 years down the pike and see how patients are doing.”

Refractec, the Irvine, Calif., company that has developed the CK technique, presented a study to the FDA showing that patients retained, on average, 94 percent of their vision correction after a year; 75 percent of the patients had 20/25 vision or better at that point.

The company is uncertain how long the benefit of CK will last, and no data are available on the safety or efficacy of repeat treatment.

“Reading glasses should be the gold standard” for people considering close-vision correction, Katz advises. “People should compare any other option against them in terms of safety, efficacy and cost.”

Refractec plans to roll out CK across the United States over the coming months. While Lasik practitioners are expected to offer the procedure, other eye doctors are likely to offer it, too. A CK machine costs about $50,000, compared with $400,000 and up for Lasik gear.