Ortho-K taking shape

Reversible LASIK alternative for myopia yields quick results

Ryan Peacock, Special to the News

Published April 3, 2006 at midnight

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When Dr. James Jordan describes the testimonials from his patients who underwent a unique vision correction procedure, they sound like well-scripted television commercials.

A local kayaker raved about being able to do white-water tricks safely again because of his improved vision, and one woman recalled sitting on a Mexican beach and being able to clearly see an ocean liner that drifted on the horizon.

They weren't praising the benefits of LASIK , the popular laser eye surgery, but rather an alternative they discovered through Jordan known as orthokeratology.

The procedure, better known as Ortho-K, trades the high-tech laser equipment of LASIK for specially designed contact lenses that are worn overnight as patients sleep. These lenses gradually reshape the corneas to correct vision problems in people who suffer from nearsightedness (myopia) with or without moderate astigmatism.

Jordan said the main advantages with Ortho-K are that it is nonsurgical, produces results within weeks, and unlike LASIK, which creates permanent changes to the eye tissue, it is reversible.

He started to offer Ortho-K in 2003 and since has done the procedure for more than two dozen patients. And the Arvada-based optometrist plans to expand from his current office to open several stores under the name EyeShapers that will specialize in Ortho-K.

Dr. Art Epstein, chair of the contact lenses and cornea section of the American Optometric Association, said Ortho-K has been around for more than 30 years.

After several developments over the past few decades, he said, the procedure is now gaining popularity.

The first development occurred with advancements in gas permeable materials that allowed people to wear lenses overnight.

"But what really pushed Ortho-K was the advent of reverse geometry lenses based on modern technology. In the early 1990s, computer- controlled lathes allowed for complex cuts in the design process," Epstein said.

Then in 2002, a company called Paragon Vision Sciences commercialized its corneal refractive therapy lenses technology after receiving the first Federal Drug Administration approval for overnight wear in the Ortho-K process.

"They really came up with a logical scheme for fitting lenses properly," Epstein said.

One of the major factors that helped push CRT technology forward was a partnership formed with NASA to perform experiments aboard space shuttle flights in the 1990s. The experiments tested the permeability and other characteristics of the company's lenses and provided valuable data to improve the CRT design.

The Ortho-K procedure offered by Jordan starts with a standard eye exam that utilizes a Medmont E300 corneal topographer. The topographer sits on top of a desk and has a small view window that fits in front of a patient's eyes. Once in place, it projects a series of illuminated rings onto the cornea surface, which are reflected into the instrument. A computer then analyzes these measurements and creates a topographical map of the cornea.

From this detailed computerized analysis, Jordan is able to determine the structure of a patient's cornea and save the corresponding data in order to design specialized lenses.

"A lot of doctors don't have these because it's tough technology to learn," Jordan said.

Corneal topographers are also used in LASIK procedures and the treatment of eye diseases.

Other technology that Jordan has integrated into the Ortho-K process includes Wave Software, an application that downloads a patient's cornea measurements and then emails them directly to a lens manufacturer. It reduces the time it takes to design customized lenses needed for Ortho-K and works on a standard PC.

Follow-up visits are scheduled to make sure the lenses are fitting properly and to monitor the structural changes in the cornea. Multiple fittings may be required. Ultimately, a patient will be given retainer lenses that must by worn overnight permanently (though some people can wear them just a few nights a week). Otherwise the corneas will return to their original shape.

Another benefit with Ortho-K is that adjusted lenses can always be created to address vision changes that normally occur as people age, Jordan said.

"I think Ortho-K will continue to grow. There are two major manufacturers (Paragon CRT and Bausch & Lomb) marketing this technology, and it has gained big market share," Epstein said. "In some practices it is now 25 to 40 percent of their business."

Jordan's Ortho-K procedure starts at around $600 per eye and includes all lenses, exams and fittings. A leading refractive industry newsletter reported that LASIK procedures averaged around $1,965 per eye in the second quarter of 2005, according to www.allaboutvision.com.

The first EyeShapers opened in early March near Arapahoe Road and Interstate 25.

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