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Primary Eye Care Associates

Corneal Refractive Therapy

By on May 06, 2014

  Corneal Refractive Therapy - A Non-Surgical Way to Correct your Vision!

 

“What is CRT?”

Corneal Refractive Therapy uses specially designed vision retainers to gently and gradually reshape the front surface of the eye (the cornea) to eliminate or reduce nearsightedness (myopia) or astigmatism. The principle is similar to the use of a dental retainer used by an orthodontist to realign crooked teeth. The vision retainers are similar to contact lenses and are only worn at night while sleeping. They are then removed upon awakening to provide clear vision without using glasses or contact lenses! The retainers are comfortable and very easy to care for.

“Why think about CRT? Why not just wear eyeglasses or contact lenses?”

The main purpose of CRT is to be free from both contact lenses and eyeglasses during waking hours. While this is ideal for sports enthusiasts or those who work in dusty or dirty environments, for others CRT offers the appeal of being free from corrective lenses during the day. CRT also offers relief from the problems sometimes associated with full time contact lens wear like drying and things getting on or under the lenses.

“Does CRT have any advantages over Laser Surgery?”

There are several. CRT is less than half the cost of Laser Vision Correction Surgery. It does not involve any post-operative pain. Also, the hazy post-operative vision that can be associated with laser surgery does not occur with CRT. Both eyes can easily be done at the same time with CRT. Also, prescription changes are easy to deal with using CRT. There are no strong steroid or antibiotic drugs needed with CRT as there are during the post-operative period for laser surgery. Lastly, and perhaps most importantly, CRT is reversible. Laser surgery is not.

“Is everyone suitable for CRT and can any doctor perform it?”

The answer to both questions is no. It does not work on every patient and needs to be performed in a very exact and meticulous manner. We have received special training and have the necessary diagnostic equipment, computer software and expertise to perform CRT.

The procedure works best on mild to moderate amounts of nearsightedness or astigmatism. More severe cases can have their vision improved, but will still need some vision correction. The procedure also does not work well on certain shaped corneas. Also, there are several unmeasurable factors for each patient - most notably the cornea’s rigidity. Thus the speed of CRT varies with each patient. Generally, but not always, less nearsighted patients respond faster than more nearsighted ones. There are no age barriers for CRT. It is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted as studies have shown that CRT may prevent any further nearsightedness from occurring! Also, while success rates are very high, success cannot be guaranteed due to factors like the inability to wear the vision retainer for physiological reasons or other systemic health problems that may reduce wearing time.

“What does the CRT procedure involve?”

A comprehensive eye health examination is performed first. Then, a corneal topographer is used to obtain a very precise computerized “map” of the cornea’s shape. This information is placed into the CRT computer software and a diagnostic retainer is fit in the office. If at that time it is determined that you are a good candidate for CRT, your own vision retainers will be ordered. It takes about one week for the retainers to be made and delivered.

When you pick up your retainers, you will be instructed on how to use and care for them. The maintenance is very easy and involves only one bottle of solution. If the retainers fit properly, you may wear them that first night. Your should see well with the retainers on.

We will see the first morning after you wear your retainers. You should come to the office wearing your vision retainers. We will remove them for you. Of course, should you experience any problems while at home with your retainers, simply remove them.

Most of the visual changes occur rapidly over the first few days. As the cornea changes shape and vision improves, we will refit and reorder successive vision retainers (if needed). During this interim period we will supply you with (no-charge) soft disposable contact lenses to be worn during the day. These are usually only needed for the first few days. For most patients, only one pair of retainers is needed.

The majority of patients achieve excellent vision in only a few days - many after only one night of wear. Even after you are seeing well, we will continue to see you a while longer to ensure your cornea is adapting to the retainers. Most patients are done with their follow up care in about one month although some may take more or less time. When the treatment is completed, the last retainer used will be worn on a nightly basis. Some patients are able to use the retainers every other night.

“How much does CRT cost?”

Depending on which of three payment plan you choose, the total fee for the entire CRT program is between $1,980 and $2,280. This includes all of the professional visits, retainer lenses needed to achieve optimal vision, and any needed interim soft disposable contact lenses. Lost, broken or spare retainers are available at a cost of $150 for each eye.

“What are the disadvantages of CRT?”

You must be prepared to allow 3 - 5 visits over a one month period. Should you stop wearing your retainers, your vision will slowly return to its original state. (Note: A new procedure called 'Corneoplasty' is currently being studied. This procedure would make the effects of CRT permanent!) While the degree of success is very high, it cannot be guaranteed. However, when the corneal topography and computer software indicate a patient will be successful, it is rare that patients don’t do well with CRT. Rates and amount of improvement vary from one person to the next.

“I’ve never heard of CRT. Is it new?”

Attempts to re-shape the cornea have been tried since contact lenses were first fit. The process used to be called orthokeratology. This process would often take over a year to complete and the results were not nearly as favorable as CRT. For this reason, many doctors and patients elected not to participate in orthokeratology. With the newer diagnostic technology used to measure the corneal shape and the newer materials being used for vision retainers, CRT is now a viable alternative for many nearsighted or astigmatism patients.

 

Click on the following link to see a video made by Dr. Chander: http://youtu.be/mK6hsdwnSQs

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