Jay,
I can't answer your question directly, but my consultant told me that around 50% of grafts done will need contacts to gain good vision afterwards.
In my case, when I saw my consultant yesterday, in the 7 weeks since the op, my vision has deteriorated from 3 lines on the chart the day after, to "what chart?" now. She then demonstrated that by wearing glasses, this deficiency is correctable (I could see 5-6 lines with the glasses she put in front of my face).
As long as any vision problems can be corrected using glasses or "regular" contacts, I don't have a problem. Before the op, I couldn't see the chart even with the best correction available.
If I may misquote L'Oreal: "Because it's worth it!"
John
Quicktopic posts: Mar 2002
Moderators: Anne Klepacz, John Smith, Sweet
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Amanda Stigle
Jay
What is the success rate in America, and how is the success rate defined?
I like John can't answer your question fully but have every confidence that ophthalmologists in the UK are just as experienced and competant surgeons as their American counterparts. Maybe the difference is that surgeons in this country operate at a later stage of the disease. Other options such as Scleral lenses are not as widely offered in America as they are here.
I am still hoping for a UK surgeon's reply soon.
What is the success rate in America, and how is the success rate defined?
I like John can't answer your question fully but have every confidence that ophthalmologists in the UK are just as experienced and competant surgeons as their American counterparts. Maybe the difference is that surgeons in this country operate at a later stage of the disease. Other options such as Scleral lenses are not as widely offered in America as they are here.
I am still hoping for a UK surgeon's reply soon.
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Ken Pullum
Transplant success in the US and UK
Discussion of the criteria for a successful or unsuccessful outcome following a transplant is a very subjective issue, so a definition is always going to be inconclusive. After keratoconus, it depends not least on whether the matter is assessed from the patient’s or the clinician’s point of view. Another variable is the visual potential before the transplant was carried out. But most important is that as there is a continuous scale up to seeing 6/6 unaided, there is no clear point on where a distinction can be made.
Ideally there should be independent evaluation, but even if this were implemented vigorously, the arbiters must have knowledge of the subject, so the choice of who to do it is severely restricted. Clinical medicine is subject to more intense scrutiny that ever before, as is evident by the fact that rarely a week passes without the TV news programmes broadcasting details of yet another hospital that is failing, or whose results are not up to standard.
I doubt very much that the results from the US are better than the UK. There is the perennial argument that the NHS is falling apart, but our surgeons and operating facilities are top flight. Mandy’s comment is probably correct. No two centres in one country are the same, but looking at the US and UK is even less of a like with like comparison. The US has about 5 times the population of the UK, but carries out about 10 times the number of transplants, ie twice as many per capita. So, there is either twice as much keratoconus, or they operate at an earlier stage. I suspect the latter is more likely. I know of one person who was a problem free scleral lens wearer of 40 years standing who was persuaded to join a short waiting list for a transplant in the US. He pulled out at the last minute. None of the surgeons I know here would have given it any consideration at all. This is only a single example, but it does show that attitudes vary.
Ken Pullum
March 2002
Discussion of the criteria for a successful or unsuccessful outcome following a transplant is a very subjective issue, so a definition is always going to be inconclusive. After keratoconus, it depends not least on whether the matter is assessed from the patient’s or the clinician’s point of view. Another variable is the visual potential before the transplant was carried out. But most important is that as there is a continuous scale up to seeing 6/6 unaided, there is no clear point on where a distinction can be made.
Ideally there should be independent evaluation, but even if this were implemented vigorously, the arbiters must have knowledge of the subject, so the choice of who to do it is severely restricted. Clinical medicine is subject to more intense scrutiny that ever before, as is evident by the fact that rarely a week passes without the TV news programmes broadcasting details of yet another hospital that is failing, or whose results are not up to standard.
I doubt very much that the results from the US are better than the UK. There is the perennial argument that the NHS is falling apart, but our surgeons and operating facilities are top flight. Mandy’s comment is probably correct. No two centres in one country are the same, but looking at the US and UK is even less of a like with like comparison. The US has about 5 times the population of the UK, but carries out about 10 times the number of transplants, ie twice as many per capita. So, there is either twice as much keratoconus, or they operate at an earlier stage. I suspect the latter is more likely. I know of one person who was a problem free scleral lens wearer of 40 years standing who was persuaded to join a short waiting list for a transplant in the US. He pulled out at the last minute. None of the surgeons I know here would have given it any consideration at all. This is only a single example, but it does show that attitudes vary.
Ken Pullum
March 2002
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Emma
Hi everyone.
I know that this topic was brought up a little while ago, but I was wanting to know about whether I should keep having to pay for contact lenses that dont seem to fit properly. I was fitted for RCPs in mid october. I kept that pair until the end of December. They were ok at first and I could keep them in for quite a long time, but they did 'pop out' a few times. Then towards the end of the two months my eyes started getting sore and red and I wasnt wearing them as much. I then got given new RCPs which are bigger as the optician said I have big eyes and that it why the last pair were uncomfortable. The problem is that the new pair are really uncomfortable and I can always feel them there. My eyes feel sore and are just as red as before. I also have problems getting them out becuase they are so big! I am going back to opticians at easter (hopefully i will get new lenses that are more comfortable!) and just wanted to know whether I will have to pay for new lenses that he perscribes?
I would appreciate anyones advice!
Emmax
I know that this topic was brought up a little while ago, but I was wanting to know about whether I should keep having to pay for contact lenses that dont seem to fit properly. I was fitted for RCPs in mid october. I kept that pair until the end of December. They were ok at first and I could keep them in for quite a long time, but they did 'pop out' a few times. Then towards the end of the two months my eyes started getting sore and red and I wasnt wearing them as much. I then got given new RCPs which are bigger as the optician said I have big eyes and that it why the last pair were uncomfortable. The problem is that the new pair are really uncomfortable and I can always feel them there. My eyes feel sore and are just as red as before. I also have problems getting them out becuase they are so big! I am going back to opticians at easter (hopefully i will get new lenses that are more comfortable!) and just wanted to know whether I will have to pay for new lenses that he perscribes?
I would appreciate anyones advice!
Emmax
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Paul C
Hi everyone. Had a busy couple of weeks - so I'm just catching up on the KC news.
It is now 7 weeks since my graft. I too had never heard of scleral lenses until I found this site, but as I was just about blind in my left eye before the graft, I cannot complain as I can now read the third row of the chart without any correction lenses.
My consultant said that there was no point in having a lens made until my graft settled down. But I still feel very lucky to have experienced such an improvement so soon after the operation.
I noticed that immediately after the op. I couldn't read small pront - even with a high power eye glass. But now, I can read small print fairly easily with the aid of a magnifyer, so I'm hoping that my eyesight can be improved further by wearing normal spectacles.
When I visited my consultant last week, I had a corneal shape scan (Tomography???). This was really interesting but I would like to learn more about interpreting the results. Does anyone know of a web site where shape scans of a normal eye can be seen. I ask this because the scan of my grafted eye although not having any red sections, was certainly not symmetrical about the centre and I wondered whether a 'good' eye would have such 'perfect' symmetry?
Also, does anyone know who manufactures the machines that produce these corneal shape scans? I am a specialist in electronic circuit/system design and would be interested in designing such a machine that could be used by an optician (or even by an individual at home).
Thanks, Paul. http://www.musicscool.com
It is now 7 weeks since my graft. I too had never heard of scleral lenses until I found this site, but as I was just about blind in my left eye before the graft, I cannot complain as I can now read the third row of the chart without any correction lenses.
My consultant said that there was no point in having a lens made until my graft settled down. But I still feel very lucky to have experienced such an improvement so soon after the operation.
I noticed that immediately after the op. I couldn't read small pront - even with a high power eye glass. But now, I can read small print fairly easily with the aid of a magnifyer, so I'm hoping that my eyesight can be improved further by wearing normal spectacles.
When I visited my consultant last week, I had a corneal shape scan (Tomography???). This was really interesting but I would like to learn more about interpreting the results. Does anyone know of a web site where shape scans of a normal eye can be seen. I ask this because the scan of my grafted eye although not having any red sections, was certainly not symmetrical about the centre and I wondered whether a 'good' eye would have such 'perfect' symmetry?
Also, does anyone know who manufactures the machines that produce these corneal shape scans? I am a specialist in electronic circuit/system design and would be interested in designing such a machine that could be used by an optician (or even by an individual at home).
Thanks, Paul. http://www.musicscool.com
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Paul C
Wouldn't surprise me! Thanks for the info though. I know they don't sell as many products as television receivers to cover their development costs - but they are not a charity either and I think they still ensure an adequate profit margin to keep the directors and shareholders in the life-style that they are accustomed to! There must be a web site somewhere though that has examples of these scans for various eye conditions - probably an academic and/or research site although if I could find out who manufactures these instruments, I would be very surprised if such companies did not have their own web site.
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Amanda Stigle
Dear Emma
If the lens you were fitted with is not suitable you should be given a replacement without further costs. If it falls out and you loose it you have to pay for the replacement. However in reality this does not always happen, varies depending on the local NHS Trust you visit.
But in your case Emma it sounds like scleral lenses would be an option worth asking about. They are large, and take a bit of getting used to. But are well worth it, and never fall out. I know what you are going through I kept replacing my lenses for a whole year because I was told there was no alternative. I was on the waiting list for a corneal graft when I was introduced to scleral lenses 5 years ago.
If the lens you were fitted with is not suitable you should be given a replacement without further costs. If it falls out and you loose it you have to pay for the replacement. However in reality this does not always happen, varies depending on the local NHS Trust you visit.
But in your case Emma it sounds like scleral lenses would be an option worth asking about. They are large, and take a bit of getting used to. But are well worth it, and never fall out. I know what you are going through I kept replacing my lenses for a whole year because I was told there was no alternative. I was on the waiting list for a corneal graft when I was introduced to scleral lenses 5 years ago.
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Philippa Sanderson
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Ian - Oxfordshire
Philippa,
I know exactly what you are referring to - they are called "floaters" - most people have them - in fact the more you think about them the worse they seem! They are more noticeable when it is very bright or your look at a white background.
They are caused by "clumps" of gel/cells in the vitreous fluid (the clear fluid that fills your eye) in the eye and are perfectly normal. What you see is the shadow on the retina. If concerned, mention it to your optician but there is usual only concern if you suddenly start seeing them or you see flashes of light too.
Tony - perhaps you could add this to the Glossary!
Regards
Ian
I know exactly what you are referring to - they are called "floaters" - most people have them - in fact the more you think about them the worse they seem! They are more noticeable when it is very bright or your look at a white background.
They are caused by "clumps" of gel/cells in the vitreous fluid (the clear fluid that fills your eye) in the eye and are perfectly normal. What you see is the shadow on the retina. If concerned, mention it to your optician but there is usual only concern if you suddenly start seeing them or you see flashes of light too.
Tony - perhaps you could add this to the Glossary!
Regards
Ian
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