Cataract surgery is the most performed procedure in the United States, and approximately 30 million people receive this vision restoring procedure. The most widespread cataract surgery procedure creates incisions in the cornea for instruments to access the old crystalline lens of the eye, remove it, and replace it with a new artificial lens. These incisions can be the cause of blurry vision after cataract surgery, as if they are not close enough to the edge of the cornea can cause corneal irregularity. If placed too close to the center of the cornea, these incisions literally act as surgical refractive incisions, and cause a local change to the corneal structure that creates irregular astigmatism across the cornea. This manifests itself as ghosting, multiple images, glare, poor contrast sensitivity, and even loss of overall resolution of vision. Many cataract surgeons are not trained to recognize corneal irregularity form cataract surgery incisions whey they occur, and will tell the patient they are doing well because they improved lines of vision on a chart. It can absolutely be the case that a patient improves in lines of vision, but still has blurry vision after cataract surgery due to the loss of clarity from the corneal irregularity.
It is possible to literally reconstruct the cornea and the original incorrect laser shape into a new even space by removing the irregular tissue segmentally micron by micron to make a regular shape again. In fact, the imaging maps created for the reconstruction treat the overall corneal irregularity including ones that could just be natural biologic in origin. This same methodology can be used to treat other surgery induced corneal irregularity or irregular astigmatism.
Dr. Motwani has also invented the procedure for treating the part of the corneal irregularity that the eye tried to “fix” itself, by variably changing the epithelial thickness (the clear skin on top of the cornea) to mask low and high spots of irregularity. These masked irregularities cannot be detected by the topography systems that create the repair map. By using a trans-epithelial approach customized by depth of epithelial compensation, a greater amount of the irregularity can be removed. This is the CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced). This has been validated in peer-reviewed original research clinical studies publications, as well as multiple United States patents and patents pending.
https://cornearevolution.com/publications/
https://drmotwani.com/dr-manoj-motwani/
The CREATE Protocol procedure reconstructs the cornea micron by micron into a more ideal, uniform shape with a reduction in overall corneal irregularity, whether surgery induced or natural biologic. It is difficult with current technology to exactly fine tune the prescription of the new improved corneal shape, so a second simple residual refractive correction enhancement is scheduled as part of a CREATE Protocol procedure 4 months after the reconstructive procedure.
The final CREATE Protocol result should improve clarity and decrease negative visual phenomena as well as create a whole new shape of the cornea which can be seen on topography and the visual results. It can allow the cataract surgery patient to have vision that could potentially be even better than what a cataract surgery would have provided in the first place.
We have created a YouTube channel with dozens of videos documenting patient interviews, surgeries, and how treatments work. Please follow the link below to watch
https://Youtube.com/@motwanilasik
https://drmotwani.com/video-gallery/
https://drmotwani.com/patient-resources/
