C3R / CXL with laser treatment

[h0tr0dder_uk]

Whilst researching vision specialists that perform C3R / CXL I received an email that stated that one of them performs this procedure followed by laser surgery if required. My belief was that laser surgery couldn't be performed on KC patients as the cornea was too thin.
Am I correct?
Has anyone had this done?
Do they wait for the C3R / CXL treatment to thicken up the cornea before doing the laser surgery?

It all sounds really good, but a bit risky. opinions please

[Lynn White]

Hi

In Europe, some ophthalmologists will do a "full procedure" to restore full vision., This may include intacs, followed by CXL followed by laser to correct the final residual RX. Although this is apparently successful, gut feelings do cringe a bit at the long term prospects! Since KC induced by lasik is something clinics try to avoid, actively lasering a KC cornea, CXL or no CXL, does not seem quite "right".

However, as you say, the argument is that CXL thickens the cornea up enough to reduce risk factors. Only time will tell if this is correct or not.

My own, absolutely personal opinion ( as in, if you have a relative who has KC what would you say - and I DO have a relative with KC!) is I would say no. A KC cornea is thin enough already without reducing it even further. Intacs and CXL can get you most of the way there and phakic implants can get rid of the residual prescription if you really want 20/20 without further risking corneal integrity. There are people out there who have had KC induced by laser surgery - its a known risk factor and the laser screening process regularly throws out people who have very mild cases of KC as too risky to operate upon. So common sense suggests its not a good idea to take these people and laser them after CXL.

Lynn

[lars]

Well, I have had this kind of treatment here in Greece. It is dr J.Kanellopoulos that does this.
The difference is that a partially topo-guided PRK (no Lasik) is used, so that the risks are reduced and the PRK is done before the CXL.
I can't say a lot about this, it is only 4 months after the surgery. Things are good until now, my vision is corrected and
I am able to see with simple daily soft lenses (60% and 70% vision). I have been in touch with one patient here that has this treatment done last year
and he is doing great (80% vision without anything), the doctor is awesome and the organisation in his clinic is excellent.
The only requirement is that the eye's thinnest local point should be no less than 450 for the prk to take place (at most 50 are removed).
If anybody wants to know more, just contact me.

[Andrew MacLean]

I guess that, as is so often the case, the answer here is "the treatment appropriate to your condition will depend on how advanced your condition has become." There was a post some time back from someone in the UK who had been refused CXL because his corneas were already too thin.

All the best.

Andrew