Laser Thermokeratoplasty

This is a form of laser vision surgery which can be used to treat hyperopia (long sightedness) and astigmatism. It differs from LASIK, LASEK or other laser procedures in that the cornea is shrunk rather than reshaped.

The thing to bear in mind with this treatment is that it is not permanent. The eyes do change, especially when we reach middle age and so further surgery may be required.

What is ‘LTK?’
How does it differ from other laser eye procedures?
Who should consider LTK?
If I am not suitable for LTK then is there an alternative?
What are the risks of LTK?
What are the benefits of LTK?
What should I ask the surgeon at the consultation?
How much does LTK cost?
What is the LTK procedure?
How long do the effects of LTK last for?
What does recovery from LTK involve?

What is ‘LTK?’

LTK stands for ‘Laser Thermokeratoplasty’ and is a form of laser vision surgery. It involves using a laser to shrink and reshape the cornea. This reshaping means that light can pass through the eye in a normal manner. Vision also becomes clearer.

This is a quick procedure which does not involve any cutting or removal of corneal tissue. It is mainly used to treat
long-sightedness.

How does it differ from other laser eye procedures?

The main differences are in the technique and the results. In the first case, a laser is used to apply a ring of small heat spots to the cornea. These areas of heat cause the cornea to contract which alters its shape. This results in improved vision and focusing power.

There is no cutting of the outer layer of the cornea – the epithelium, which occurs with LASEK, LASIK and PRK.

And, secondly, the results are short term only which means further surgery will be required. The eyes are often ‘overcorrected’ to take into account the ‘regression’ in the patient’s eyesight. In fact, you can expect to lose a great deal of the corrective effects of your new eyesight in the first 3 months following surgery.

Conversely, LASEK, PRK and LASIK have long lasting or even permanent effects.

Who should consider LTK?

LTK tends to be carried out on patients aged 40 and over as the effects are temporary. Another factor is having a low level of hyperopia (long-sightedness).

It helps to have stable vision – in other words, your prescription has not changed over the last 2 years and to be in a good state of health.

Apart from this, the usual factors for suitability will apply. These include lifestyle, medical history and reasons for surgery.

If I am not suitable for LTK then is there an alternative?

Yes. Intra-Ocular Lenses (IOL) or Implantable Contact Lenses (ICL) and Conductive Keratoplasty (CK) are good alternatives. In fact, CK has largely replaced this procedure.

Your surgeon will assess your suitability for a laser eye procedure make a decision based upon that. If he/she feels that you are not suitable then he/she will recommend alternatives.

What are the risks of LTK?

All forms of laser eye surgery have risks although these are rare. However, complications do happen and it’s as well to be aware of these before going ahead with surgery.

The main ones with LTK are:

Foreign body in the eye: you may feel as if there is an object in your eye after surgery but eye drops will deal with this.
Temporary nearsightedness (myopia): surgeons tend to ‘overcorrect’ with this procedure which can result in temporary short-sightedness. You may find that you have to wear glasses or contact lenses for the first few weeks after surgery.
Light sensitivity: you may experience some mild sensitivity to light but this will ease after a day or so.
Risk of developing astigmatism.
Regression: this procedure is not permanent. You will find that your eyes start to return to their pre-operative state within the first 3 months after surgery. It has been found that many patients lose all the corrective effects within 2 to 3 years after surgery.

What are the benefits of LTK?

These include the following:

Very quick procedure
Little risk of infection
Little risk of vision loss
Little pain or discomfort

You will find that you are able to return to work, and your normal activities the very next day.

What should I ask the surgeon at the consultation?

Visit the ‘Laser Eye Surgery: General FAQS’ section for further information. This section also contains a list of questions to ask at your consultation.

How much does LTK cost?

Costs vary from one clinic to another. As a general guide, prices can start from £1,000 per eye although this is a rough estimate only.

What is the LTK procedure?

The surgeon will put local anaesthetic drops in your eyes to numb them before surgery. He or she will then use a laser which emits heat to shrink the cornea. It does so by heating small, dot shaped areas of the cornea.

This will cause the cornea to contract (shrink). And, the curvature of the cornea becomes steeper.

What does this mean for you? This means clear vision as light will be able to pass through the eye in a normal fashion.

How long do the effects of LTK last for?

The one disadvantage to this procedure is the fact that the results don’t last that long. Eye surgeons are aware of this and tend to ‘over-correct’ your eyes: by this we mean that he/she will compensate for this regression by correcting your eyes more than they need to.

This over-correction may mean that you have some degree of short-sightedness. You may have to wear glasses or contact lenses for the first few weeks as a result of this.

You will find that your vision will start to regress in the first 2 to 3 months following surgery, and then, at a much slower rate over the next couple of years.

However, some studies have shown that the effects can last much longer than that. In some cases they can last for 5 even 10 years.

But, this is still seen as a temporary procedure only.

What does recovery from LTK involve?

The one advantage here is that this procedure does not involve any cutting or burning of the cornea. This means a very fast procedure with no downtime.

You will be given antibiotic and anti-inflammatory drops to prevent your eyes from becoming infected. Painkillers are available if you experience any pain or discomfort although this tends to be rare.

You will be required to attend the clinic the next day, just to check up on your progress. This will be followed by a series of regular check ups over the next few months.