UK Keratoconus Self-Help and Support Association

I had INTACS surgery on my left eye on 21st May 2008. I had one INTAC SK inserted into the inferior section of my eye, as this was considered to be the best option for my inferiorly placed cone. Four main reasons for having it done:

1. The cone was progressing to a steepest reading of 60.3D, with an average of 51.8D;
2. The cone was thinning so at the thinnest point it had reached 335 microns.
3. My prescription was poor at around -5.00, -5.00 and Axis: 150. Contact lenses were starting to prove uncomfortable.
4. My specialist said that this would be best way to slow or stop progression as we were both concerned about possible grafts

No problems post op and thankfully so far i do not have any pain or discomfort at all. Also I dont seem to be getting any problems with halos or flare, although as its summer I am not out in the dark that much!

Last week went for the removal of my stich and first post op topography. There have been a number of changes to the topography which all appear to be good, although my consultant was a bit confused by some of the readings. I dont think it has done as much changing as he expected. However he did do the test a few minutes after he removed the stitch so its still settling down. My new readings from the topography and from my optoms exam of me from last week (with stitch still inserted) are:

1. Cone steepest point now at 54.1D, a drop of 6D. Average D has dropped to 49.8D;
2. The thinnest part of the cone is now 385 microns, an increase of 50;
3. Post op presription (which is still changing) is around 1.75, -1.75 Axis 180

Because my vision was bad beforehand and the KC quite advanced its difficult to see a massive daily improvement but this morning there does appear to have been some changes for the better. Its odd that my vision does seem better in the mornings than the evenings and I am wondering whether anyone in the forum has experienced this before or heard of this? Any explanations or understanding on why this happens would be greatfully received.

When I get copipes of my topography scans before and after (next week) I will post them for anyone who is interested.

Finally I am having my right eye done in late August and will be having INTACS followed by CXL about 2 weeks thereafter. I know some people onthe forum have been asking about this so I shall try and post once that is done.

Even slow progress is heading in the right direction!

All the best with your second INTACS surgery.

Andrew

Hi GrifterUK

Intacs often do not do a great deal for reducing prescription but sure do for Higher Order Aberrations. At the Group conference last year, we had a presentation by a couple of people who had had intacs and this is what they reported. Vision was improved by the removal of distortion. Basically you benefit from the intacs making your cornea a more regular shape.

As for it being different in the morning to the afternoon.. two things to consider:

The cornea is influenced by the pressure of the lid closed on the eye during sleep - this wears off during the day.

The cornea also gets more oxygen during the day as it absorbs it from the atmosphere - at night it has to make do with oxygen absorbed from the capillaries in your lids.

Will be very interested to see your topographs!