Corneoplastics

[timtim]

Well after talking to my eye doctor, he says that he wants to see me about having his new procedure sometimes referred to as Corneoplastics (said he doesn't like to give names but this is what its been called) done on me instead of Intacs. He re-shapes the Cornea with a laser like in Lasik and said it has delivered "amazing" results. His name is Dr. Arun Gulani, and he is quite an amazing eye doctor (google his name if you want to read about him). Anyways, I'm very excited about the possibility of this and can't wait to get in to see him

[Andrew MacLean]

Hey tim

This does sound exciting. Keep us posted.

Andrew

[Lynn White]

Tim

I have looked at this website and see no actual information concerning "corneoplastics" and keratoconus. All I see is intacs relating to KC and corneoplastics relating to normal refractive surgery.

I am just a little concerned because usually laser surgery tends to accelerate keratoconus. Could you direct me to the appropriate place on the website?

[timtim]

I read an article a few months back about this, but can't find it now. What you said is concerning, and I'll make sure to bring it up to him when I meet with him next Friday. Again, he sounded very confident and said that its a different technique than Lasik (I just don't know the specifics). Will keep you updated what I find out, and will also link to that article about it if I can find it.

[Lynn White]

Thank you...

I am concerned because I am not sure what this technique is and the website does not explain it. It certainly is not a verified technique in the UK or Europe. In fact, as far as Europe is concerned, laser technology is implicated in triggering sub-clinical KC to become full blown KC. I am now further concerned because you cannot explain this from information from the clinic nor can verify it from the website.

All I can say is that as far as the KC treatment options in the UK are concerned, this is not a viable option that has been trialled. If any professional has further information that could assist Tim in his decision making, I ask that you post here.

[bluegums80]

Hi Everyone,

I am not a professional, but a fellow KC-er (who actually did have LASIK without knowing that I had forme fruste KC and as Lynne discusses, have ended up with full blown KC in one eye and not so good in the other, either.) I wanted to say that I visited Dr. Gulani this past summer upon hearing about this corneoplastic technique, and what he recommended for me was a DALK (partial transplant), which was pretty much in line with what other doctors have recommended. Perhaps he has other options for people whose eyes are not as advanced as mine, but I agree with Lynne about being careful with lasers if you have anything like KC.

I got the impression after visiting Dr. Gulani and reading up a little more on his approach that the corneoplastic techniques that he mentioned were more applicable to people who had complications after LASIK that were not connected to KC/ectasia.

I will be interested to hear what Tim finds out. Please let us know, Tim, and good luck.

[timtim]

I found the article about Corneoplastics that I was looking for...

http://www.osnsupersite.com/view.asp?rID=22138

I think I'm a bit confused on it all right now. Maybe some of you can help out by reading that article (hopefully it will work for you, because their website was down for a lot of the day today). I don't see a part about using a laser, so maybe I am confused about the method he was talking about.

[Lynn White]

Thanks for that Tim

I have been doing some research of my own and yes, laser has been used in KC. However, any laser work generally removes tissue and if you are doing this on an already thin cornea, then there is a risk that it can make things worse. The bottom line is that, like many new procedures, its long term worth won't be proven one or another for a while yet. Its interesting that Dr Gulani suggested DALK for Bluegum.

I know its confusing Tim, but the thing here is that no-one here can offer you advice on this as everything depends totally on the state of your eyes and none of us can actually see them! Even if a hundred people here had a procedure done successfully, it still would not be of any use to you if your eyes were not suitable. You could get an opinion from another ophthalmologist before you go ahead with anything.

[timtim]

Well I went in to see him this morning...just got back. My dad went with me as well to help me out. I will try to explain what he said as well as I can, and as well as I understood it...and I apologize if I don't explain everything as well as possible since I'm not an expert on it, and some of it is a bit confusing.

He said that what he does is use the laser to just basically shave off a very, very small amount of the outer part of the cornea. In my case, he said my left cornea was about 470 microns thick (Had never heard this number used but this is how he explained it). He said that in order to improve me vision he would have to get rid of about 25 microns (making it around 445). He said that he feels this is a small enough removal of tissue to where it won't be very harmful to the KC. He said that very few doctors do this procedure for KC, but he feels it can really improve the vision. He has been doing it on KC patients for 5 years, and said he has done about 25 patients. He said none of those patients have needed any further treatment since then, but he also warned us that he doesn't want us to judge based on this since every patient is different.

We asked him about what happens if my KC progresses and starts thinning. He said that the next step would be to get Intacs if this was to happen. He seems very confident with it, but it also seems a little bit concerning since it is such a little known process.

The positive thing is, he has been friends with my dad for a few years, and made sure that he only wants to do what is in the best interest for me....he would never try to push us into something that he didn't 100% think was going to be beneficial. He also urged me to talk to other surgeons, and people who have other opinions before we make a decision. THis was comforting too. He said that most other surgeons will go straight for Intacs because they do not know how to perform this method.

Hope that helped some, and I would love to get any feedback if anyone can find out any info to help us with this. Our next step is to try to find out as much as we can about it before we decide. If you have any more questions, let me know, and I'll do my best to answer or explain things better.

[timtim]

After doing some research online, this link is what seems to be the most like what he is talking about.

http://www.escrs.org/eurotimes/august2002/prk.asp

I don't recall him calling it PRK, but maybe it is close to it, or he calls it by another name.