What RK did, and what it left
RK made four to sixteen deep radial cuts in the cornea, which flattened its center and reduced nearsightedness. The incisions never fully regain strength. Over decades the cornea continues to flatten, shifting many patients into farsightedness, and its shape fluctuates with corneal swelling, so vision is often different in the morning and evening. The central optical zone is small and may be irregular where incisions were uneven. All of this makes both glasses and stock lenses unsatisfactory for many RK patients.
Why standard lenses fail
A stock soft lens drapes over the flat center and steep periphery and decenters, and its optics cannot correct the irregularity. A standard rigid lens rocks on the flat center and can bear on the incisions, causing discomfort, and it does not address the day-to-day shift. Neither is a stable answer for most RK eyes.
The lens options
Scleral lenses are the mainstay. They rest on the sclera and vault the cornea, so the corneal shape, its irregularity and its daily fluctuation are neutralized by the fluid layer beneath the lens, and nothing touches the incisions. Vision is stable through the day. Reverse-geometry rigid lenses, designed with a steeper periphery, suit some milder RK corneas. Custom soft lenses help patients with a regular RK cornea and a simple prescription. Fitting uses tomography, and the vault over the incisions is checked carefully, with imaging where appropriate.
RK and cataract surgery
Many RK patients are now of cataract age, and cataract surgery in an RK eye is planned carefully, often with the Light Adjustable Lens. Scleral lenses remain useful afterward for patients whose corneal irregularity limits the vision a lens implant can deliver, and are refitted once the eye has settled.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is the right choice for you is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Arbi Melikian, OD. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
