Joel Weiner, a financial planner from the Lehigh Valley, had worn glasses since fourth grade. Six years ago, at age 45, he had LASIK surgery to correct his severe nearsightedness, and was thrilled with his new perfect vision. Then he reached his late 40s, and found himself needing specs all over again, this time for reading. He was at that stage in life when people begin to hold a menu or newspaper at arm’s length. This inevitable condition of aging, called presbyopia, makes it difficult to focus on near objects.
When Weiner heard about a new procedure called conductive keratoplasty (CK), specifically designed to correct presbyopia, he called Dr. Alan Leahey, the refractive eye surgeon in Allentown who’d done his LASIK procedure. In a three-minute, noninvasive operation, Weiner’s focus problems were eliminated. “I had some discomfort for a few days — it felt like having an eyelash in my eye,” he says. “But compared to LASIK, this was easy. I got rid of all my reading glasses in the trash.”
CK, which was approved by the FDA last year to treat presbyopia, uses a radio frequency probe to make a series of tiny spots in a circular pattern around the outer edge of the cornea. (It’s only done in one eye.) The spots shrink small areas of collagen, allowing the reshaped cornea to focus better up close. The procedure can be repeated as needed, to a 32-spot maximum. “Because CK is new and presbyopia is progressive, we don’t yet know how long the effect lasts,” Leahey points out. “People are likely to outgrow it over time. That’s why many are taking a wait-and-see approach.”
Among those waiting are doctors at Wills Eye Hospital. “It’s new and exciting, but the results are just not solid enough yet,” says Dr. Peter Laibson, director of the Cornea Service at Wills. “The procedure does cause scarring of the cornea — although it’s not in the visual axis — and until we have more long-term information on how it holds up, we are going to be conservative.”
Doctors who are performing CK agree it’s not for everyone. Dr. Michael Aronsky, of the Kremer Eye Center in King of Prussia, has already done hundreds of cases at around $2,000 a pop, but says he’s turned away an equal number of patients. Anybody with serious vision impairment isn’t a candidate. The bigger problem, though, is adjusting to mono-vision — having different vision capabilities in each eye. Contact lens wearers have been using mono-vision for years, with a distance prescription in the dominant eye and a close-up prescription in its mate. Usually the mind accommodates the two. With CK, only one eye is corrected, and there can be difficulties with depth perception and possibly distance vision. Aronsky screens potential patients by fitting them with one near-vision contact lens and having them wear it for few days. “If they’re comfortable, they’re in,” he says. “But for many, it just doesn’t feel right.”
Sue Stagliano was the ideal patient. A saleswoman at Nordstrom, she’d had perfect vision until age 52, when she struggled to read sizes and price tags without glasses. Customers turned her on to Dr. Aronsky. “He was extremely thorough,” she says. “I was tested and measured in three different visits. I did CK two years ago, and the very next day I could read every ingredient on my makeup bottle.”