CK PROCEDURE In the clear

It takes a few weeks for the eye to reach the final level of correction.
By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
aby boomer alert.
Do you see well for distance, but find yourself needing those bothersome reading glasses for close-up work?
Then turn on the radio -- radio frequency waves that is -- and your vision can dramatically improve, painlessly and almost instantly.
With no slicing or dicing, your cornea is reshaped and you can discard those "granny glasses" that you can't find half the time anyway.
If you have a half-hour or so -- five to 10 minutes for the procedure itself -- good eyesight except for close-up work, and $1,500, you're in business.
It's not even in-patient. It's in-office.
The seemingly miraculous "it" is conductive keratoplasty (CK), a minimally invasive procedure that uses heat from the controlled release of radio frequency energy to shrink the collagen in a circle around the cornea.
When the collagen shrinks, it acts like the tightening of a belt and increases the curvature of the cornea, which has flattened with age, and sight for near distance is restored, said Dr. A. Zeev Rabinowitz, a Youngstown-area ophthalmologist.
Side effects
With the exception of some blurring immediately after the procedure, caused by the anesthetic eye drops, and eyes that are scratchy and light-sensitive for a couple of days, normally there are no side effects, said Dr. Rabinowitz, a partner in the Belmont Eye Clinic, with offices in Liberty, Austintown and Canfield.
There is almost zero recovery time needed because there is nothing invasive from which to recover, said Dr. Rabinowitz.
The affected eye completes its readjustment within a few weeks, although in a few cases people have needed a touch-up, Dr. Rabinowitz said.
The result is that patients can once again read a book without glasses.
They can read prescriptions or labels on products at the grocery store instead of asking the kids what they say.
They can grade papers or do surgery, all without glasses or contacts, Dr. Rabinowitz said.
CK uses a technique called blended vision. Unlike monovision, where one eye is treated for near vision, leaving the untreated eye for distance vision, blended vision improves the ability to focus on near objects without dramatically affecting distance vision in the treated eye.
Though CK is not surgery -- there is no knife or laser beam involved -- it is minimally invasive in that a probe that is thinner than a strand of human hair is applied just under the surface of the eye in a circle around the cornea.
What to expect
Before her CK procedure July 6 at the Belmont Eye Clinic in Canfield, Freda Martin of Mahwah, N.J., was only able to read the largest letters on the eye chart.
Immediately after sitting up in the chair after her CK procedure, she was able to read letters halfway down the chart, even with vision still blurry from the eye drops.
Like Martin, patients usually notice an immediate improvement in their vision. But it usually takes a few weeks for the eye to reach the final level of correction, Dr. Rabinowitz said.
CK is essentially painless (Martin said the most bothersome part was the retractor used to keep her eyelid open), and the cost is within reach of a lot of people, which is important because it is not covered by most insurance policies.
CK would seem to be the quintessential "boomer" experience. It works, it is easier than getting your teeth cleaned, and you can get back on the treadmill (work or exercise) the same day.
The main reason the CK procedure is aimed at so-called baby boomers, those people born between, and including, 1946 and 1964, is that they are 40 to 58 years of age.
During those years, all people experience presbyopia, an age-related eye condition that negatively affects near vision in otherwise healthy eyes, Dr. Rabinowitz said.
Hyperopia is farsightedness and myopia is nearsightedness.
What occurs in presbyopia is a loss of accommodation, or the ability to adjust from distance to near vision, Dr. Rabinowitz said.
This is his explanation: The eye muscle contracts and relaxes to change the shape of the lens and thereby change the focus of the eye from far to near. When people age, the liquid in the lens hardens and the muscle can't change the shape of the lens, making it difficult to see things up close.
Performing the procedure
Another reason for the anticipated popularity of CK is the sheer number of baby boomers.
Some estimate the number of boomers in the United States at 76 million, about half of whom are eligible for CK, said Dr. Kong Oh of Oh Eye Associates in Boardman.
Dr. Rabinowitz and his partner, Dr. Sherif I. Hanna, were for several months the only ones in the area doing CK procedures. Dr. Rabinowitz himself has done about 70 procedures.
However, this month, Dr. Oh said he performed CK for the first time; and the Internet lists doctors with offices in Grove City and Butler, Pa., offering CK.
Special training and equipment is needed for the CK procedure, said Dr. Rabinowitz, who got into refractory eye surgery 25 years ago. Refractory surgery can be used to correct focusing problems that before that were only correctable with glasses or contact lenses.
Dr. Rabinowitz said it cannot yet be said the results of CK are permanent because the procedure has been used for only three years.
But, even if it lasts for only five years, it is something that allows a patient to extend his ability to read and see without glasses, Dr. Rabinowitz said.
alcorn@vindy.com