Can Scleral Lenses Help Patients with RK Scarring?

Radial keratotomy (RK) was a popular vision correction surgery in the 1980s and 1990s. While many patients enjoyed clear vision for years afterward, some eventually develop complications such as corneal scarring, irregular astigmatism, and fluctuating vision. At Insight Vision Optometry in Las Vegas, our specialty contact lens team regularly helps RK patients regain clear, stable vision using custom scleral lenses.

What Happens to the Cornea After RK Surgery?

During RK surgery, small incisions were made in the cornea to reshape it and reduce nearsightedness. Over time, these incisions can weaken the corneal structure, leading to irregular corneal shapes, epithelial splitting along the incision lines, and scar tissue formation. Patients may notice their vision gradually worsening, becoming more distorted, or fluctuating throughout the day. In some cases, surgical repair of the corneal surface is needed, which can leave behind sutures and additional scarring.

How Do Scleral Lenses Restore Vision After RK?

Scleral lenses are large-diameter gas permeable contact lenses that vault entirely over the cornea and rest on the white part of the eye, called the sclera. The space between the lens and the cornea is filled with preservative-free saline, creating a smooth optical surface that neutralizes corneal irregularities from RK incisions, scars, and sutures. This means the light entering the eye is focused properly, often resulting in dramatically improved vision that glasses alone cannot achieve.

Why Custom-Designed Lenses Matter for Complex Cases

For patients with significant corneal scarring or sutures, a standard scleral lens design may not provide the best fit. Custom scleral lenses, designed using advanced 3D imaging of the eye’s surface, allow our doctors to create a lens that precisely matches each patient’s unique corneal and scleral contours. This personalized approach ensures safe clearance over scars and sutures while maximizing visual clarity and comfort.

A Real Patient Success Story From Our Las Vegas Practice

One of our most rewarding scleral lens cases involved an 80-year-old patient who had undergone RK surgery years earlier. Over time, she developed epithelial splitting along her RK incisions that required surgical repair and corneal sutures. She also had dense cataracts in both eyes. Given the combination of corneal scarring, irregular shape, sutures, and cataracts, expectations for her best achievable vision were modest.

During the initial evaluation, a diagnostic scleral lens was placed on her eye to assess visual potential. To our surprise, she achieved 20/30 vision with just the diagnostic lens. After designing custom scleral lenses using 3D imaging of her eyes, her final results were remarkable: 20/25 in one eye and 20/20 in the other. At her one-year follow-up, her vision remained stable, the lens fit was excellent, and she had no complaints.

What Should RK Patients Know About Scleral Lenses?

• Scleral lenses can often achieve better vision than glasses for patients with RK scarring and irregular corneas.
• Custom lens designs are especially important for eyes with sutures, scars, or complex corneal shapes.
• The fitting process typically involves 3D imaging and may require one or more follow-up visits to optimize the lens.
• Scleral lenses also help with dry eye symptoms, which are common in post-RK patients, by maintaining a layer of moisture over the cornea throughout the day.
• If you experience sudden vision changes, severe eye pain, or new flashing lights, contact your eye doctor immediately, as these may indicate a serious condition requiring urgent attention.

Schedule a Scleral Lens Consultation in the area

If you had radial keratotomy surgery and are struggling with blurred, distorted, or fluctuating vision, scleral lenses may be an excellent option. Dr. Stephanie Woo, OD, FAAO, FSLS, Dr. Nathan Schramm, OD, FSLS, FBCLA, and Dr. Thanh Mai, OD, FSLS specialize in fitting scleral lenses for complex corneal conditions at Insight Vision Optometry. Call us at 702-747-4070 or visit insightvisionlv.com to schedule a consultation.