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Dr. Michael R. Obregon
Optometric Physician
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Home » Eye Care Services » Corneal Refractive Therapy (CRT)

Corneal Refractive Therapy (CRT)

Girl wearing contact lenses in Coral Gables, FL

Corneal Refractive Therapy (CRT), is a treatment used to correct myopia (nearsightedness) or astigmatism by wearing customized high-oxygen contact lenses overnight, so that no corrective lenses are needed during daytime hours.

CRT practitioners use specially designed reverse-geometry lenses, which are inserted at bedtime and worn when sleeping. Throughout the night, the lenses reshape corneas gently so that patients wake with clear vision the following morning. The correction is temporary, and provides clear, crisp vision without the need for eyeglasses or contact lenses the following day. In order to maintain sharp visual acuity on a daily basis, CRT reshaping lenses are worn every night.

Candidates for Corneal Reshaping

CRT is most suitable for nearsighted people who are otherwise poor candidates for vision correction surgery or contact lenses, such as children and teenagers. Individuals of all ages with healthy eyes can try CRT, namely because it can be discontinued at any point without permanent effects to the eyes.

People who require vision correction and engage regularly in sports or work in extremely dusty, dirty environments will also appreciate the convenience of corneal reshaping.

Vision Results from Corneal Reshaping

Success rates for CRT are generally higher for more mild vision prescriptions. The ideal goal is to provide 20/20 vision without any need for eyeglasses or contacts during the day.

According to FDA trials conducted, more than 65% of CRT patients achieved 20/20 visual acuity. More than 90% of patients achieved 20/40 vision or better (this is the legal requirement for driving without vision correction in most states).

Although improvement in vision is generally reported within a day or two of wearing CRT overnight, the full effects may not be experienced until the lenses are worn for a few weeks. During this transition period, vision may not be as crisp as it was with regular contacts or eyeglasses, and some patient may exhibit glare or halos around lights. Until CRT works fully, a temporary pair of eyeglasses may be required for specific actions, such as driving at night.

How Does CRT Feel?

Although some people have trouble wearing regular gas permeable contact lenses during the day, CRT shapers are highly oxygen permeable and worn while sleeping – so discomfort and awareness of the lenses in the eye is generally not an issue.

What is the cost of CRT?

Professional fitting for reshaping therapy requires a series of visits to the eye doctor. Progress evaluation and shaper assessment is an important part of the process, and both are performed at regular pre-scheduled intervals. The special CRT shaper design is more complex and sophisticated than regular gas permeable lenses, and manufactured precise microscopic tolerance.

This is reflected in their higher cost. The total cost of a Corneal Reshaping Therapy Program is generally combined in one fee which covers fitting, evaluation, and follow-ups, as well as the shapers.

As to be expected, the first year cost for this tailored therapy is substantially more than a regular contact lens exam + contacts. Subsequent year fees for established CRT patients are considerably less. Many offices offer financing arrangements to cover the increased costs.

LASIK after Corneal Reshaping

Some consider CRT to be a non-surgical alternative to LASIK. While CRT is an alternative, refractive surgeries are still possible after a treatment program.

Because CRT works to reshape the cornea, discontinuation of the program is required before undergoing LASIK. This allows the eyes to return to their original shape, and further highlights the flexibility and convenience of a fully reversible treatment.

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