CORNEAL REFRACTIVE THERAPY
The world of eyecare is one of the fastest-evolving fields in medicine today. Never before have there been so many new techniques and scientific breakthroughs. Corneal Refractive Therapy (CRT) is a safe, non-surgical contact lens procedure to reduce or eliminate blurred vision caused by nearsightedness and astigmatism. It dramatically improves the natural vision. CRT was developed in 1962 and has provided corrective care to thousands of patients through this therapeutic application of contact lenses. A series of special lenses is fit in stages to gently reshape the cornea and improve vision without surgery or damage to the cornea.
Benefits of Corneal Refractive Therapy
The basic purpose of Corneal Refractive Therapy (CRT) is to improve visual function using custom contact lenses, shaped specifically for each patient. In people of all ages with increasingly stronger prescriptions, corneal refractive therapy can slow down or stop the ever-increasing need to get stronger glasses. Not everyone can presently benefit by this procedure. Yet, for many, this is a safe, non-surgical approach to improving and restoring vision. The doctors at Arizona’s Vision will evaluate your eyes and your vision to determine whether you are a good candidate for corneal refractive therapy. As shown in the video below, Arizona’s Vision is a Certified Wave™ Designer, one of the advanced technologies we use for custom contact lens fitting and as an applied technology within CRT.
Corneal Refractive Therapy Program
On the first day of your procedure you should arrive at the office as rested and relaxed as possible. Expect this visit to last approximately one hour.
The new contact lenses will be placed on your eyes by your doctor or an assistant. You will have an adaptation period of 10 to 20 minutes. During this time, you will feel a slight awareness of the lens on the lid and eye, much like an eyelash. Your eyes may tear in response. You will be instructed in the proper method of lens insertion and removal and the hygiene associated with cleaning the lenses. You will be given all the solution and instructions necessary to handle this at home. During this instruction, you will need to demonstrate proficiency with insertion, removal, and centering of your lenses.
The doctor will then discuss your lens-wearing schedule with you. To ensure the best possible results, it is essential that the wearing schedule be followed closely. Your exact wearing schedule depends on the severity of your myopia and your lens-wearing success. During night wear, the eyelid covers the lens, resulting in very little lens movement. The lenses are highly oxygen-permeable, so the cornea will not be deprived of oxygen even when the lenses are worn while sleeping.
After the initial session of contact fitting, you will be scheduled for an appointment two days later. This is a very important visit since the cornea and resulting vision are rapidly improving at this stage. This exam will include determining unaided visual acuity, corneal curvature, and corneal topography. The objective and subjective refraction determines your new vision correction, and biomicroscopy evaluates the health of the eye. A refitting of new accelerated contact lenses as necessary or possible contact lens modifications may take place. The doctor will discuss the new wearing schedule.
Follow-up appointments are usually scheduled for two-weeks, one-month, and six-months, but can vary from doctor to doctor. When your doctor determines that your maximum desired results have been achieved, a retainer lens program will be arranged with yearly follow-up exam. The wearing schedule of retainer lenses will range from wearing them every night to wearing them only one night per week.
Topographical map of right eye, before CRT treatment Corneal topography after CRT treatment
Results vary from person to person, so it is not always possible to predict your exact response to this therapy. Myopia, or nearsightedness of mild or moderate degrees (20/200 or better), usually can be corrected to 20/20-20/30. Higher degrees of myopia may gain dramatic improvement, allowing that person to function without lenses. Astigmatism of moderate amounts can also be reduced or eliminated, enhancing visual performance. With today’s advanced computerized lens design and manufacturing equipment, better and faster results are obtained. The contact lens materials have also made technological advances, allowing better safety and retention.
Rare Risks and Complications
Your eyesight changes slightly over time, even if you do nothing to enhance your vision. This does not mean this procedure is unstable. Many outside factors affect vision progression, like age, eye growth in children and close work, as well as other factors. However, in most patients, vision does not change significantly with proper retainer lens wear.
Eye infections are extremely rare with the program of reshaping the cornea. As with all contact lens wear, infections are avoided through proper hygiene and proper lens wear along with careful monitoring by your doctor. If infection does occur, it is important to contact your doctor so treatment can begin immediately. Most infections respond to antibiotics, but it will be necessary to discontinue your Gentle Molding lens wear while an infection is active.
It is important that your doctor be aware of any dry-eye problems you have prior to beginning the procedure. Tell you doctor if you experience dry, scratchy symptoms or if you frequently use “drops” to lubricate your eyes to receive relief from dry-eye problems. With aggressive treatment, many people with slight to moderate dry-eye problems can be successful, safe wearers of contact lenses.
Links to Further Reading
Paragon CRT® Corneal Refractive Therapy