Laser Reconstructive Corneal Repair became possible in the United States when topographic guided ablation was FDA approved. This type of procedure selectively removes irregularities in the cornea, which is the main focusing part of the eye. Irregularity and warpage that has been caused to the cornea from past surgery (Radial Keratotomy or RK, AK, LASIK, PRK, LASEK, ALK), traumatic corneal distortion, or disease caused corneal irregularity can now be corrected by reconstructing the cornea rather than just correcting it. It can also be combined with corneal cross linking to treat Keratoconus and other forms of corneal ectasia. In fact, the use of this procedure invented by John Kanellopoulos, MD and termed the Athens Protocol, has become the gold standard worldwide and helped many patients avoid the need for corneal transplants.
The Wavelight Contoura system is the best recognized and most powerful topographic system available in the United States. It has been used in the rest of the world for over a decade to treat corneal irregularities, but only certain doctors worldwide perform the procedure. In the United States, the system was first FDA approved for use in primary laser correction patients, those who had never had any form of surgery before. The FDA approval does include the use of Contoura for corneal repair and treatment of irregularity and warpage as a precaution to the surgeon, which literally means the surgeon should understand that corneal repair treatments are not the same procedure as primary laser correction treatments.
Dr. Motwani first developed the LYRA Protocol (Layer Yolked Reduction of Astigmatism) to utilize the full power of Contoura, and demonstrated how a more uniform cornea could be made utilizing the FDA approved Contoura system. These principles were applied to corneal repairs, resulting in the San Diego Protocol which was published by Dr. Motwani for corneal reconstructive repairs.
This website contains medical imaging, technical data, and notes that are designed to not only be resource for prospective patients, but also eye surgeons who wish to better understand these procedures. It is therefore far more technical than most refractive surgery websites.