UK Keratoconus Self-Help and Support Association

Hello All,

Yesterday I visited the London Centre for Refractive Surgery (LCRS) for a C3R consultation. I thought I would fill you in on how it went and let you know about a few things I found quite interesting.

Just to give you a brief description of my KC. I have had it for approx 3 years and it has progressed rapidly in this time, with my left eye the worse affected. Till now I have only worn soft torics giving me average vision, but not adeuate enough to drive. Hard RGP's have not yet been used as I play county cricket and these would not be suitable. My NHS consultant thought C3R was a waste of time and advised me to use sclerals or have a graft on my left eye within the next few months. I dont have any k readings or copies of my topographys but my GP classed my KC as 'moderately severe' if that helps.

Anyhow I went to this consultation with very little hope as I did not think I would have the adequate corneal thickness (general rule 400 microns). But I learnt many things I did not know before!

Firstly I was told I would be suitable for C3R which was a real surprise. My right eye had 464 microns of thickness which is great, However my left eye at its thinnist was 264 microns. However I could still get C3R done on this eye as I have a sub condition of KC which only affects the side of the cornea (cant remeber the name) and is off centre. The consultant (Dr. Jory) explained that by using distilled water on this area it would swell up the cornea to make it thicker and this has been tried before successfully.

Now I asked that after this procedure could I be fitted with INTACS. Dr.Jory really surprised me on this one by saying I could have INTACTS fitted now but they would not be suitable for cricket as I could cause damage to the eye if I were hit by a ball. This confused me as a few months earlier I had been told by my NHS consultant that I was not suitable for INTACTS at all. Still not sure what to make of that?

Dr.Jory advised that after atleast 6 months of the C3R I could consider having a toric lens implanted which would give better vision then INTACTS. I did not have time to go into this subject further with him as I was getting late for my train! But I will bring this up with him on my next appointment.

Is there anyone who could shed further light on this for me as I had never heard of it being a treatment method for KC but rather for cataracts.

Also as the LCRS now do Mini Ark I enquired about this and was told it is only suitabke for people who are at the very early stages of KC.

Kaz

Kaz

Thank you for the very full information. There are some real surprises here that will probably give hope to lots of readers.

I hadn't heard of Toric Lens implants being used as part of the management of KC. Is this to rreduce astigmatism, or is it intended for another purpose (is it possible, for example, that you also have a cataract?).

All the very best. Do you have a date for your C3R, or are you still considering options?

Andrew

I have been treated by Mr Jory too and he also mentioned lens implants as a possible for me also. I think he uses it where patients have a high degree of astigmatism but it is a treatment which the centre have been doing for years to correct high astigmatism on other non KCers. I believe he has used it on patients who have had lazer vision correction but have been left with problems. Last time I saw him he had done 10 patients with C3R in 8 days!
Helen

Andrew I don't have cataracts so Helen must be right in that the lens implants are used to correct high levels of astigmatism.

Helen you probably have more knowledge on this then me as I didn't get time to discuss it with Mr.Jory. I was wondering if after having the lens implants if I would still need correction? Or could I be able to return to wearing soft dailty disposable lenses?

I am due to go ahead with the C3R treament in October. As my KC is quite advanced I am not expecting any improvement in vision but would be happy if it stops progression allowing me to avoid a graft. If it doesn't work for me atleast I tried!

Kaz

Kaz
My guess is you will need to discuss this more fully with your consultant. There is more than one type of lens implant and I suspect what he is talking about is effectively a contact lens implant which is where your own internal lens is retained and the toric lens implant is in addition to that - it is not the same as a cataract where the internal lens is removed and replaced.

There is further information at
http://www.eye-care.org.uk/item_view.ph ... ntent_id=6

hope that helps! And good luck!

After developing a cataract on one of my eyes, they implanted a lens, but I still need glasses.

The iLase website says that C3R does not offer a guarantee of prefect unaided sight, but they do suggest that it can be offered along with other interventions such as an intraocular lens or INTACS.

Summary.
C3R strengthens the cornea and halts the progression of keratoconus and corneal ectasia. It may be used alone, or in conjunction with other treatments such as INTACS or excimer laser vision correction or phakic intraocular lenses, to produce the optimum visual result (see the relevant i.Lase information leaflets). When the cornea has stabilised, glasses or contact lenses may be required to provide the best visual outcome.

I know that everybody here wishes you all the very best with this, and we will all be keen to learn how things are working out for you.

Yours aye

Andrew

Thanks for the weblink Pat it explained alot. I now remember my consultant saying it was the Artisan lens.

The ARTISAN Lens
The most widely-used phakic ICL in Europe is the Artisan (Ophtec) iris-fixated ICL. It is used to correct hyperopia, astigmatism as well as extremely high degrees of myopia (up to -23.5 dioptres). This type of contact lens implant is placed permanently into the eye with the aim to reduce or eliminate the use of glasses or contact lenses.

Up untill now I did nor know this was available to people with KC. I wonder how many people have had this procedure done?

Kaz