Spokane ophthalmologist Dr. David Cohen has begun offering a procedure that uses radio waves to correct the near-vision deterioration that everyone over the age of 40 eventually suffers.


Using a patented technology called Conductive Keratoplasty, which was developed by Irvine, Calif.-based Refrotec Inc., Cohen essentially reshapes the patients cornea to bring near vision back into focus. Use of the technology was approved for that purpose last month by the U.S. Food and Drug Administration, though it has been employed as a way to treat age-related deterioration in far-point vision since 2002, Cohen says.


Cohen began performing the procedure last fall, under an FDA provision that allows physicians to use experimental technology on patients if they make full disclosure that it has yet to be approved. So far, he says he has performed about 50 near-vision CK procedures, and he believes hes the only one in Spokane for now who is doing it.


The procedure corrects whats called presbyopia, the age-related eye condition that affects most people after the age of 40 and everyone by their 50s, Cohen says. Presbyopia, which is believed to be due to an age-related loss of flexibility in the eyes natural lens, causes near vision to fade, making it difficult to see things up close, such as while reading, doing hobbies, and even checking the time on a wristwatch, he says.


Refrotec estimates that 90 million baby boomers either have presbyopia or will develop the condition in the next 10 years.


Presbyopia is one inescapable vision disorder that will eventually affect us all, Cohen says. The frustration many people feel with the on-again, off-again annoyance of reading glasses cannot be overemphasized.


The procedure isnt for everyone, though. According to Cohen, eligible patients must meet three criteria for him to perform the procedure: They must have good distance vision, they must be at least 45 years old, and they have to hate their reading glasses.


Cohen charges about $1,200 per eye to do the procedure, including exams, though he says often only one eye needs to be corrected. The procedure isnt typically covered by insurers.


Refrotec says clinical-trial data collected at the 12-month follow-up on patients who have had the procedure showed that 98 percent could read magazine- and newspaper-sized print without reading glasses, and 87 percent could both see 20/20 off in the distance and read the smaller, phone-book-sized type without glasses. No significant side effects were found, the company says.


Doing the procedure is somewhat an art of compromise, Cohen says. Because eligible candidates can see distances well, Cohens challenge is to correct patients near-vision deficiencies without hurting their far vision.


He says he does that by first doing an eye test on the patient, trying a collection of lenses to determine what kind of a correction would improve near-vision yet retain far vision. Usually the result is a decision to make a correction to one eye that has near-vision deficiencies and leave the other eye alone. With one eye strong at far vision and one strong at near vision, the brain automatically uses the strengths of both, without the patient noticing that each is performing somewhat different tasks, Cohen says.


Using information from the eye test, Cohen then plans the procedure, including where the patients cornea will be manipulated.


The procedure itself only takes about 10 to 15 minutes, and the only anesthetic used is a topical eye drop.


In simplest terms, the procedure reshapes the cornea by tightening it along a perimeter around the pupil, in effect steepening the cornea in front of the pupil. Its like tightening a belt, Cohen says.


He accomplishes that by firing radio waves into the cornea at specific, predetermined locations in a circle around the pupil. The energy in the waves shrinks small areas of callagen in the cornea, causing it to constrict. The radio waves are generated by a desktop console and are transmitted into the cornea via a tip in the handheld device thats a fraction of the width of a human hair. Cohen looks at the cornea through a microscope while performing the procedure.


Theres no pain or recovery time from the procedure, and the patient should start showing signs of improved near vision the following day, though it sometimes takes three months before the eye stabilizes and the full benefits of the procedure are experienced, he says.


Cohen and his wife, Vernice, both underwent the procedure last year in Texas, because we wanted to see if it would help us before we offered it to others, Cohen says. He says both of them benefited from the procedure and dont need glasses now for near-vision tasks.


Cohen is a principal in Eye Consultants PS, an eye clinic located at 235 E. Rowan on Spokanes North Side.