Kertatoconous, C3R and Intacs

[srini_satya]

Dear All,
I am a Indian citizen and recently was in Germany. I lost my contact lens and soon after I came back to India, I went to an Opthal for a eye check up. He recommended C3R and this was done as well (I am in the 2nd week after the surgery).
I have Keratoconius in both the eyes and left is quite bad when compared to the right eye. As usual, I am asking opinion here...is Intacs a must? I did not want to tamper with the natyural eye as far as possible. What are the pros and cons of getting the intacts done? Do I have an iption of not having anythign done and go towards soft contact lenses and corrective glasses? My age is 42 and I am quite fit. No diabetes and/or hypertension. I run 10 kms and walk about 5 with weights on...let me know if you have any suggestions at all. Thanks & best regards, Satya

[Lynn White]

Hi Satya,

What you are asking is impossible to answer without more details about your eyes. The decision to go for intacs depends a lot on the vision you get with contact lenses and how well you tolerate them. In any case, intacs, if you are going to do it in combination with C3R - or CXL as it is now known as - is best done after intacs, not before.

Intacs are used to make the cornea more regular when there are high levels of corneal distortion or astigmatism present. If you already get reasonable comfortable vision with contact lenses, then intacs are probably not going to help a great deal. Sometimes intacs do have to be removed because reflections from the implants can be seen in the central vision.

CXL will hopefully halt any progression and usually there is some improvement over a couple of years, so on the limited information you have given, I would say that you are OK with what you have done so far - especially if you do not like to tamper any further with your eyes.

Lynn

[srini_satya]

Dear Lynn, Thanks for the reply. I was quite comfortable with the contact lens. There was no immediate concern with the RGP lens that I was wearing. Since this is all quite new and lots of eye clinics would have invested in expensive instruments, I am quite concerned about the "rush" for intacs or ICL.
I am willing to wait and see how the cross linking is going to take place.
My left eye is about -16 where as my right eye is about -8. Glasses cannot be used to get me a good vision. But lens can be prescribed for correctiing the vision to soem extent? Can I go for soft contact lens? Will I have to go for RGP knowing the limited number of hours (8) that I can wear usign the RGP lens?
Please let me know your answers in a generic thumb rule fashion, I knwo it is hard to advise with out actually seeing my eyes. I believe there are scars in the cornea - on both eyes...what good and bad things can I infer from these scars? Best Regards, Satya

[Lynn White]

Hi Satya,

OK that helps a lot more.

Scarring can occur from several causes, including episodes of hydrops (where there is a rupture in the cornea) and scarring from RGP lenses that may have been fitted too flat. It is difficult to say what your scarring was from without seeing your eyes. The scarring tends only to be significant when it is in your line of sight.

It is possible to fit you with soft lenses - there are several types available including Soflex, KeraSoft, Acuity. I can tell you more about KeraSoft as I am a consultant for the company. However, what counts really are their availability and I know for instance, there is not a distributor for KeraSoft yet in India. If you want to look at websites, you can find them at:

http://www.soflexcontacts.com
http://www.kerasoft3.com
http://www.acuity-lenses.co.uk

It is also possible to fit your RGPs so they piggy back on top of thin Silicone hydrogel lenses - this can give you longer wearing times.

Are you returning to Germany as you may get better access to different types of contact lenses there?

Lynn

[srini_satya]

Dear Lynn,

THis has been extremely helpful. I keep travelling and if I end up in UK or in the ASG area, I should be able to get the lens. Thanks much for the replies...I shall read through the URLs you have provided. Best Regards, Satya

[Andrew MacLean]

Satya

I have nothing to add to what Lynn has said, but I do want to welcome you to the forum!

All the best.

Andrew

[srini_satya]

Dear Andrew and Lynn,

Post your replies I had gone to my Ophalmologist and got myself the RGP lens. I have deferred the procedure for ICL for an other 6 months - till such time the C3R completely stabilizes. But the issue is - I am not able to see the sunlight once I wear the RGP lens. Is this an issue?

Lynn, will you be able to send any material you have showing advantages of soft vs. RGP lens for a situation like that of mine. Also, will your company be able ship me the custom made lens from KerraSoft so that I can wear tham and see the difference?

Please let me know...thanks, Satya

[jamesar]

DON'T GET INTACS. They have caused me much pain and misery for over 1 half years now. If you are going to get surgery you may as well get a corneal graft. Better success rate too. Don't let them talk you into Intacs, believe me

[srini_satya]

James, I believe you. I have not read good things about Intacs especially with the night vision. Thanks again for the caution. These days you do nto know why certain doctors ask for certain surgeries...it is always pays to be careful! Satya

[dweezil1968]

i couldnt have Intacs as something was 'too steep' so i had a graft in left eye. so far so good, intacs will work for some. Just make sure you get plenty of advice and opinions from your specialists.
good luck!