Piggybacking

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Grant
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Piggybacking

Postby Grant » Mon 11 Nov 2013 1:48 pm

Like most KC sufferers when I searched for information on KC the option of piggybacking was frequently mentioned. I mistakenly thought I understood how they worked and believed they consisted of some type of hybrid two-layer but-effectively-one-lens solution. Having been unexpectedly** fitted with piggybacks last week the following might be helpful for others.

Firstly, it's two completely separate lens, not a close-coupled hybrid as I'd assumed. The soft lens is incredibly thin and very prone to folding and curling when being handled. They're also very easy to turn inside out and it's not all that obvious when it is inside out. Putting them in seems more fiddly than either kerasofts or RGPs, the flimsy nature seems to make them end up rolled up on your eyelashes rather than in the eye. Also, given they have minimal strength (mine are -0.25) it's more difficult to tell if they're in or not - it was obvious if the kerasofts or RGPs were in because either I could see or I couldn't.

Once in, the normal RGPs are put on top of the soft lens just as if you were putting them in on their own. Comfort is obviously subjective but I would say they are more comfortable than just RGPs and only slightly less comfortable than just softs.

They were fitted on Thursday and it was only when I arrived home from the hospital that I realised that we hadn't discussed removal techniques - oops. Do they come out together, do you have to do something different? Turns out the RGP comes out just like normal and then the soft comes out using the normal soft removal method. The things you learn when calling the clinic in a mild panic.....

4 days in and I'm pretty happy with them. It's taking 10 minutes longer in the morning to faff about getting them in but comfort is excellent and I'm getting 6/5 in one eye and 6/8 in the other (hopefully getting that to 6/6 with a new lens on order)

Hopefully this will be useful to someone, if you have any questions please ask away.


** I was fitted with RGPs for the first time about four weeks ago and they were causing corneal abrasions so on the follow up visit the hospital suggested piggybacks and fitted them then and there.

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andytraill
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Re: Piggybacking

Postby andytraill » Mon 11 Nov 2013 6:44 pm

Hi Grant,

Glad you are enjoying them. :) I used piggybacking for quite awhile. For me it was much better than RGPs (was a wow moment) though the wear time was too short for going to work so I've had to change.

As for removal you can (well I did...)just go straight to the (easier) soft method (move to the side etc). The soft has to float as normal so there is no problem moving it to the side.

One tip that helped me a lot was switching the soft for a fresh one (another monthly I mean, it'll probably be a monthly soft?) half way through the day. Mainly helps with dryness and so redness, you don't use any more of them because is just using it half and half. Many days I hit a "itchy" dry wall about 4 hrs in so the switch bought me another few hours.

I would say if they do start to nip (especially because you are using them for both eyes, I was only one), switch the soft lens. If then even after switching the soft for a wet one, it still nips then take both hard and soft out for the rest of the day (from that eye). If you leave them it will just agro up your eye and next day you'll be more likely to have problems from the start of the day.

Hope that helps but usual thing, not a professional just another patient so best to speak to your consultant to verify.

Cheers,
Andrew

Grant
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Re: Piggybacking

Postby Grant » Mon 11 Nov 2013 6:56 pm

Thanks Andy, useful tips. I think I'm very lucky with my eyes in comparison to many others with KC . I put my lens in at 6.30am today and 12 hours later they still feel fine, I don't seem to suffer from dry or itchy eyes - I was wearing the softs and RGPs for 12 to 16 hours a day without problems which makes long work days easier to cope with.

GrandPaClanger
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Re: Piggybacking

Postby GrandPaClanger » Thu 14 Nov 2013 4:35 am

Make sure you do keep the eye well lubricated. Even if you feel fine as the soft lens can dry out. This is especially important before you remove the soft lens ( put some drops in first). If not it can be more stuck than you are bargaining for. I did it once and ended up in casualty, most painful thing in my life. Having said that my epithelium was very weak anyway by that point and removing the soft lens was alway a nightmare because I could not see a damn thing.

Ian

Grant
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Keratoconus: Yes, I have KC
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Re: Piggybacking

Postby Grant » Thu 05 Dec 2013 8:24 am

A quick follow up after a month with piggybacks. Comfort is still good and 15 hour days are doable, my eyes are staying well lubricated and the vision is excellent. Had a couple of occasions where I've managed to remove the soft lens first before the RGP - not sure how but could be a good party trick....

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Sweet
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Re: Piggybacking

Postby Sweet » Sat 07 Dec 2013 7:39 pm

Grant, yes I have managed to remove the soft one before the RGP, not sure how though!

I have piggybacked in my right eye for about five years I think. Thankfully Moorfields have now changed my soft lens to daily ones which saves on time! I get 6/6 vision on good days and can wear them for about 18 hours. I try to have one day a week lens free but this doesn't always happen!

My left eye is very bad and only get about 6/60. I have had a DALK but because I had a lot of scarring before it, the scan didn't help much. I am used to only really having sight in one eye and manage well piggybacking in one eye.

Read about soft lenses being hard to tell which way up they are. If you put a drop of solution in it will tell you! If the lens is the right way up it will hold this, if it is inside out the edges will look more curved outwards and the lens will try to curl itself up. If the lens is very painful when you put it in, it could be inside out or have particles on it. Best to remove it, check it's the right way, clean it and try again.

I love piggybacking, without the soft lens i can only tolerate the RGP for 30 minutes as it is so painful.

Claire Xxx
Sweet X x X

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