For patients with a history of radial keratotomy (RK), achieving clear and comfortable vision can be a challenge. Irregular corneal surfaces, scarring, and higher-order aberrations (HOAs) often persist long after surgery, making traditional correction methods less effective. However, new advancements in scleral lens technology are offering renewed hope for these complex cases.
Recently, Dr. Nathan Schramm, O.D., FSLS, was featured in Optometry Times for research with Dr. Xifeng Xiao, PhD on premium wavefront-guided scleral lenses, which demonstrated significant improvements in visual quality for patients with RK-induced corneal irregularities. His findings reinforce the potential of customized scleral lens optics in addressing post-surgical vision challenges.
Understanding the Challenge: Post-RK Higher-Order Aberrations
Radial keratotomy, a once-common refractive surgery, involved making incisions in the cornea to correct myopia. While effective at the time, RK has left many patients dealing with unpredictable refractive shifts, corneal instability, and HOAs decades later. These aberrations can cause glare, halos, ghosting, and poor contrast sensitivity, making everyday tasks like driving at night particularly difficult.
Standard refractive correction—whether in the form of glasses, soft contact lenses, or even standard scleral lenses—often fails to address these complex optical distortions. This is where wavefront-guided scleral lenses come into play.
The Case Study: A Breakthrough in Scleral Lens Technology
Dr. Schramm and Dr. Xifeng Xiao, PhD, treated a 72-year-old woman with a history of radial keratotomy (RK), which left her with vision issues despite multiple correction attempts, including standard scleral lenses.
By using advanced wavefront-guided scleral lenses (≥10th Zernike order), they were able to correct higher-order aberrations (HOAs) more effectively than traditional options.
- In her right eye, the Premium Wavefront-Guided (WFG) lens corrected HOAs up to the 12th Zernike order, significantly improving vision.
- In her left eye, the Premium WFG lens corrected up to the 10th Zernike order, outperforming standard scleral lenses.
Testing confirmed sharper, clearer vision, proving the superior optical clarity of these advanced lenses for complex RK cases.
Why This Matters: The Future of Custom Wavefront-Guided Optics
This study demonstrates that higher-order aberrations can be effectively managed with advanced scleral lens technology, even in patients with severe corneal irregularities. With high-resolution dynamic wavefront aberrometry, precise aberration measurements allow for the design of custom HOA-correcting lenses, offering patients visual quality that was previously unattainable.
For clinicians specializing in specialty contact lenses, myopia management, and corneal disease, this research provides valuable insights into the growing role of wavefront-guided optics in improving patient outcomes.
Advancing Patient Care Through Innovation
As technology continues to evolve, custom scleral lenses are proving to be a powerful tool for patients with irregular corneas. The ability to correct higher-order aberrations at such a precise level opens new possibilities for post-RK patients and others struggling with optical distortions due to corneal disease or post-surgical complications.
Dr. Schramm’s research serves as an important reminder that innovation in contact lens design is not just about vision correction—it’s about improving quality of life.
For practitioners looking to expand their expertise in wavefront-guided scleral lens fitting, this study reinforces the importance of leveraging advanced aberrometry and custom lens designs to provide the best possible vision for patients with complex needs.
Changing Lives, One Patient at a Time
Dr. Schramm and the team at Insight Vision Center Optometry is more than correcting vision—it’s transforming lives. Whether it’s helping a keratoconus patient regain crisp, stable vision or guiding a child through vision therapy for academic success, we are proud of the impact we have on our community.
If you or a loved one is struggling with keratoconus, post-surgical vision issues, severe dry eye, or corneal conditions, we are here to provide answers, hope, and cutting-edge treatment options.
