More than 20 years ago, a new technology was unveiled to help address presbyopia: conductive keratoplasty (CK). This used electrical current to cause 8 (or 16) focal burns in the peripheral cornea with a goal of steepening the central cornea. This additional corneal dioptric power helped to shift the eye towards mild myopia, thereby improving near vision in presbyopic patients. It was typically done in the non-dominant eye as a form of mini-monovision. And it worked, for a while at least until the patient became more presbyopic or the corneal steepening regressed. When you see a patient with these 8 focal spots in the cornea, how should you adjust the IOL power calculation? In this case our patient wants a trifocal lens and is quite motivated to be free from using spectacles for near vision. Remember that while hyperopic LASIK changes the anterior curvature of the cornea but not the posterior, this conductive keratoplasty (CK) can change both anterior and posterior. My best pearls for success in these cases is elucidated in the video.
