Hawaii's Near Vision CK  Leader

Frequently Asked Questions

About NearVision CK

(Conductive Keratoplasty )

1. Does NearVision CK have FDA approval?
In March 2004 the US Food and Drug Administration (FDA) granted approval of the ViewPoint CK System for performing the NearVision CK procedure. It is the first and only FDA approved vision technology that improves near vision in the millions of baby boomers with presbyopia, the age-related eye condition that sets in after age 40. Since approval in March thousands of NearVision CK procedures have been performed worldwide which clearly demonstrates the patient demand for a vision correction procedure to help eliminate dependence on reading glasses, and the procedures safety and effectiveness.

2. How is NearVision CK performed?
NearVision CK uses radio waves, instead of a laser or scalpel, to reshape the cornea and bring near vision back into focus. NearVision CK is performed using a small probe, thinner than a strand of human hair, that releases radio waves. The probe is applied in a circular pattern on the outer cornea to shrink small areas of collagen. This circular shrinkage pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia (eye drops).

3. Will you be cutting the cornea?
No. NearVision CK is performed without the cutting or removal of tissue. It is a safe, minimally invasive procedure for baby boomers who struggle to read a newspaper, menu, alarm clock or computer.

4. Is radiofrequency (RF) energy safe for use on the eye?
Yes. The use of RF energy is one of today's most advanced surgical techniques. In addition to its use in NearVision CK, RF technology is being used in prostate cancer therapy, back surgery, even cardiovascular procedures.

5. Will my vision improve immediately after the NearVision CK procedure?
Patients usually notice an immediate improvement in their near vision after the NearVision CK procedure. However, it usually takes several weeks for the eyes to adjust to the final level of treatment.

6. Will my vision fluctuate after NearVision CK is performed?
Most patients will experience mild fluctuations in their vision after the procedure. This fluctuation usually subsides within a few weeks. It is important to understand that there is a stabilization period following NearVision CK. This period influences some patients' vision more than others. The treated cornea is reshaping and adjusting itself.  Most fluctuation occurs in the first two weeks, but the eye will continue to stabilize beyond that for up to one to three months or more. This stabilization varies from patient to patient. 

7. Do I need to have one eye treated or two; and if I have both eyes treated will they be done on the same day at the Honolulu Eye Clinic?

NearVision CK is typically performed on one eye. These patients usually have the non-dominant (or weaker) eye enhanced for near vision by CK treatment. About 30 percent of the time, however; both eyes need to be treated. These patients may have some distance correction that needs to be treated also by CK so that the two eyes work will together comfortably following the procedures.
When both eyes require treatment, the eye that will have the better distance vision will generally be treated first. This will lessen any disturbance to your distance vision as sometimes happens when both eyes are done at the same time.
In some cases however, both eyes may be treated at the same time. If this is done, the patient may go through a temporary period of blurry distance vision. This may require temporary distance glasses to be used until the healing results in clearer distance vision.

8. NearVision CK achieves "Blended Vision". What does that mean?
CK takes advantage of 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 your ability to focus on near objects without dramatically affecting distance vision in the treated eye. Data collected in FDA clinical trials on the procedure have shown relatively little effect on depth perception and the ability to distinguish contrast under day and night conditions.

9. Can CK be performed on eyes previously treated by LASIK or after cataract surgery? 

Yes. Performing CK after cataract or LASIK surgery is an acceptable “off-label” practice. When a drug or device is approved for medical use by the U.S. Food and Drug Administration (FDA), the manufacturer produces a “label” to explain its use.  Once a device/medication is approved by the FDA, physicians may use it “off-label” for other purposes if they are well-informed about the product, base its use on firm scientific method and sound medical evidence, and maintain records of its use and effects. 
LASIK or cataract surgery patients often develop the need for reading glasses following those procedures. Many doctors throughout the US and abroad are already using CK for patients following LASIK and cataract surgery.

10. Will I have to wear a patch over my eye after the NearVision CK procedure?
No, you will not have to wear patches or bandages.

11. How soon can I return to work?
With NearVision CK, the majority of patients are able to return to work and other normal activities the day after their procedure. Although recovery is fairly quick, it is advisable to be careful with your eyes and to avoid any strain. Those whose jobs demand intense clarity of vision (such as dentistry, surgery or computer work) may want to give their eyes some extra rest for several days following the procedure before going back to work.
 

12. What will I feel during the NearVision CK procedure?
The NearVision CK procedure is considered painless. You will be aware of an eyelid support which helps to hold your eye open (lid speculum). The most common sensation that patients experience is a feeling of pressure on the eye. After the procedure, there may be some mild discomfort. Many patients experience a foreign-object sensation or "scratchiness" in the eye. This usually subsides within 24 - 48 hours of the procedure.

13. What type of anesthesia is used during the NearVision CK procedure?
A local anesthetic in the form of eye drops is used to numb the eye.

14. Why doesn't NearVision CK use a laser?
NearVision CK is a non-laser procedure that uses controlled radio waves to improve near vision. Rather than removing tissue with a laser, NearVision CK reshapes the cornea using an entirely different method: the application of low-level, radiofrequency (RF) energy applied in a circular pattern on the outer cornea, to shrink small areas of corneal tissue. This circular pattern acts like a belt tightening around the cornea to increase its overall curvature and temporarily improve near vision. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia (eye drops).

15. Will the instrument used in the NearVision CK procedure penetrate my cornea?
NearVision CK is performed using a probe (Keratoplast^™ Tip) that is as thin as a strand of human hair. The probe, introduced into the cornea, applies controlled radiofrequency (RF) energy, stabilizes the CK procedure and guarantees the precise depth of treatment.

16. What are the risks and side effects of NearVision CK?
Because NearVision CK is minimally invasive, the procedure has exhibited very minimal risk and almost no side effects. During the first 24 to 48 hours after NearVision CK, you may experience tearing and some discomfort, including a foreign-object sensation in the eyes. You may also experience initial slight over-correction of your vision, which stabilizes during the following weeks. However, because NearVision CK doesn't cut or remove tissue, many of the side effects associated with other vision treatment procedures have not been observed with NearVision CK.

17. Are there restrictions after having NearVision CK?
As with any vision treatment procedure where the cornea is altered, certain precautions should be taken. After the NearVision CK procedure, patients should avoid getting contaminated water in their eyes for at least one week. This includes water from swimming pools, spas, lakes and the ocean. When showering or taking baths, patients should keep their eyes closed in order to avoid getting soap and dirty water into their eyes. When exercising, sweat should be kept out of the eyes for at least a week after the procedure. Also, patients should avoid rubbing their eyes vigorously for two weeks following the procedure. Patients should avoid applying eye makeup for three days after the procedure.

18. Am I guaranteed 20/20 vision following NearVision CK?
No doctor can absolutely guarantee a certain result from any vision treatment procedure. However, in the FDA clinical study, nearly 87% of patients had 20/20 vision while looking at objects in the distance and were able to read phonebook-size print (J3) after having NearVision CK (12-month follow-up data).

19. How long will the improvements from NearVision CK last?
Currently, no one knows exactly how long the treatment will last. It varies from patient to patient because of eye anatomy differences. CK patients are encouraged to think of their treatment much like one considers cosmetic and other age-defying procedures. CK may last from 3 to 5 years, occasionally less, occasionally more. After this period the patient can go back to glasses or contacts or one or more retreatments with CK may be possible. The years of relief from dependence on reading glasses are most often seen as a compelling reason to have the procedure.

20. Will I ever need glasses or contacts immediately after NearVision CK,  or again in the future?

The vast majority of patients do not have to use corrective lenses after the CK procedure to do functional reading tasks. Glasses may be needed for more demanding visual tasks such as driving at night and perhaps prolonged computer use. However, depending on your age and the type of refractive disorder you have, you may need additional vision treatment at some point (CK or other surgery, reading glasses or contacts). This is because your eyes continue to change as you age, and no one can avoid presbyopia, which is the natural result of aging that occurs as the lens in your eye loses flexibility. 

21. Can NearVision CK treat myopia (nearsightedness)?
No, because NearVision CK was designed for baby boomers who struggle to read menus, price tags or see their computers — symptoms of fading near vision which require a steepening of the cornea. NearVision CK is not designed to flatten the central cornea, the effect required for the treatment of myopia.

22. Is NearVision CK reversible?
No, because, as with most vision improvement procedures, NearVision CK is not reversible. Once the procedure has been performed, it is not possible to "remove" its effects. This is an important factor for anyone thinking about undergoing a vision procedure to carefully consider. To make sure NearVision CK is right for you, seek the advice of your doctor.

23. Will my health insurance cover the cost of the NearVision CK procedure?
Because NearVision CK is considered "elective surgery", most health insurance plans do not cover it. There are a few plans that offer some benefits. Employers' flexible spending plans may offer tax advantages for the procedure. Please consult your employer's plan administrator if you have questions about this.

• Are over age 40
• Had great vision your whole life
• Require reading glasses to compensate for fading near vision
• Have had no drastic changes in vision or eyeglass prescription within the past year
• Have no eye conditions such as glaucoma, severe dryness, keratoconus, herpes of the eye, aggressive keloid formation or corneal dystrophy
• Have no physical conditions such as diabetes, pregnancy or nursing, and vascular or autoimmune diseases

25. How is a precise amount of radiofrequency (RF) energy and depth of treatment ensured during the NearVision CK procedure?
The technology used during the procedure was engineered and designed specifically for performing NearVision CK. This means that the precise amount of RF energy needed to affect the corneal tissue, at the precise tissue temperature and depth of treatment, were meticulously investigated and defined. The Keratoplast™ Tip penetrates the cornea to a depth of 450 µm and utilizes a plastic stop at the very distal portion to assure precise depth.

26. Can NearVision CK be performed on patients who have a pacemaker?
No. The NearVision CK equipment can produce interference that may adversely influence the operation of other electronic equipment. Therefore, NearVision CK is contraindicated for patients who are wearing a pacemaker.

27. What enables NearVision CK to be performed in-office?
NearVision CK is a minimally invasive procedure that does not require cutting of the cornea, and therefore does not carry the associated risks or surgical complications. The procedure is relatively quick and easy to perform — taking an average of just 3 minutes.

28. What does the cost of NearVision CK include?
The cost of your treatment varies from patient to patient. The cost is comprehensive and includes a thorough pre-treatment refractive eye exam, the procedure itself, and post-procedure exams as determined by the doctor. There is no doctor or clinic charge for enhancements, if required, during the first year (only the treatment tip (device) fee charged by the manufacturer of the CK system). After one year, should the patient be a candidate for and desire a re-treatment or booster treatment, the Honolulu Eye Clinic will perform this at 50% of the then current fee. To determine your costs, please telephone our clinic and ask to speak with our CK Patient Coordinator.

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