Failed to manage with Piggy-Back lenses

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Failed to manage with Piggy-Back lenses

Postby Andrew MacLean » Sat 14 Feb 2009 6:19 pm

I was at a clinic last week with my exceptionally talented optometrist.

Everybody here knows that I think she is part of an exceptionally talented team. To save their blushes, I'll not identify them this time, but they know who they are, and so do many members of the forum.

I am still struggling a bit with the lens I wear in my left eye. The optometrist (whom we shall call 'B'), tried to introduce me to piggy backing. 'Good idea', you might think; others have tried this combination of soft lenses and hard and it has worked wonders for them. 'B' has other patients (or do we have to call ourselves 'customers' or even 'clients' in the modern market age?) whose lives have been transformed by piggy back lenses.

Sadly, I am not to join the happy throng of piggy-back wearers. My eye grew 'hot' very quickly on the insertion of the soft lens, and although I could see well with the optical RGP lens over the soft under-lens, my tendency to dry eye made the whole enterprise a failure.

Still, I can get six hours with my RGP by itself, and the sight in my other eye is very good when corrected by glasses. I am not complaining.

Andrew
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Re: Failed to manage with Piggy-Back lenses

Postby Graeme Stevenson » Sat 14 Feb 2009 6:37 pm

Andrew

Sorry to hear the piggy back option isnt working for you at the moment.
in the same way as with RGP lenses I would say dont give up so soon. There are many different materials and fittings available for the carrier lens. Ideally all piggy-back lens wearers should have a silicone hydrogel lens as the carrier although financial constraints often result in conventional hydrogel lenses being issued.SiHi lenses include the brands Acuvue Advance abd Oasys,Biofinity,Air Optix,Purevision,Clariti and the ultimate contact lens a daily disposable Silicone Hydrogel lens Acuvue TruEye. I had a youung patient in today who wears the TruEye in both eyes under the RGP lens and has little if no trouble.
A silicone hydrogel lens maximises oxygen permeability although two weekly and monthly replacement can complicate things a little with regard to handling and solution restrictions.Remember you cannot use RGP solutions even for the RGP lens. A daily soft lens is ideal although the only silicone hydrogel daily is the TruEye and it can be rather expensive. You can also find that the soft lens can change the fitting of the RGP lens and that can be varied by changing the power of the soft carrier lens.
PM me if you want further info.
Regards
Graeme

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Re: Failed to manage with Piggy-Back lenses

Postby Andrew MacLean » Sat 14 Feb 2009 7:02 pm

:D Thanks Graeme. I think that part of the problem last week was that my eye had begun to object to the attention it was receiving.

I go back to the clinic in a couple of months and will see what is suggested then. I didn't have any great expectations of anything when I went to my routine appointment and was not disappointed when my eye got so distressed; nobody had built u any expectation in me and I did not even know that piggy backing was likely to be explored.

As things stand, I wear glasses with a blank lens over my left eye. Behind that lens I wear an RGP. I hve very good sight in my right eye with glasses, and very good sight in my left eye when I can wear my lens. My problem (that limits my lens wear time) is contact lens dry-eye. My lens is absolutely bone dry when I take it out.

I did use preservative free hypermelose for some time, but I am now using Optive and have ordered some clinitas on the www. I was interested to see private104's post about his having been advised to use clinitas, and I am looking forward to being able to share experiences with him and others. Maybe if we can crack this dryness, other options will open up to me.

Hope all is well, and I have not forgotten the thought of meeting for a coffee sometime I find myself in your part of the City Centre.

All the best.

Andrew

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Re: Failed to manage with Piggy-Back lenses

Postby rosemary johnson » Sat 14 Feb 2009 9:19 pm

Re: "you can't use RGP solutions even on the RGP lens" (sorry if that's not quite verbatim).
That gave me a nasty shock - because I'v ebeen piggybacking for s few years now and never thuught of changing the hard lens solutions!
But then, I'm using daily disposables - so maybe it isn't so critical then?
Mind, but the time I put the combination in together (dd soft lens inside scleral) the only things around on them in other than minutes quantities are isotonic (ish) saline and ceeluvisc.
I do have the advantage of not getting probelsm with dry eeye - or I didn't till theyR put me onto the anti-glaucoma drops!! - ut I found even when the anti-grlaucoma drops were making me wake up with half my head feeling deydrated three tmes a night, the most effective treatment was to get up and drink two or three glasses of water! - much more effective than the eye drops they suggested. Mind, I did then get woken up in the night for an additional reason.....
Andrew, sorry to hear of your dry eye problems and that piggybacking isn't working out.
Maybe a stupid suggestion, but could you possibly be one of those strange people for whom piggybacking might work the other way up (ie. hard lens in firt and soft lens on top??
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Re: Failed to manage with Piggy-Back lenses

Postby Graeme Stevenson » Sat 14 Feb 2009 10:33 pm

Rosemary
you do have to be carefull with RGP lens solutions when used in combination with any soft lens. Having said that its not such a risk if the RGP is rinsed with saline.Having said that you dont get the benefit of the RGP conditioning solution if you rinse it from the lens.
Wearing a soft lens on top of the RGP is actually called a reverse piggy-back and can be very successful for some.I do have some research info on it and the reasons it might be used which I will attempt to find and post later.
Solutions are potentially a great problem and changes in soilution can make an amazing differnce to many cl wearers.
Regards
Graeme

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Re: Failed to manage with Piggy-Back lenses

Postby Andrew MacLean » Sun 15 Feb 2009 9:06 am

One benefit has already accrued from the failed attempt to get me to wear piggy back lenses: we now know that the limit to the time I can wear a lens each day is not a matter of 'lid sensitivity', but a matter of dry eye.

Andrew
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Re: Failed to manage with Piggy-Back lenses

Postby Pat A » Sun 15 Feb 2009 12:57 pm

When I was piggy-backing I was advised to use a solution suitable for both RGP and soft lenses -called "Quattro" and that seemed to work fine - just a shame the piggy backing didn't, probably for the same reasons as Andrew - i.e. Dry eye.

Quattro is available from www.postoptics.co.uk

Pat

By the way, Hi to all - I am still around just don't often post these days :roll:
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Re: Failed to manage with Piggy-Back lenses

Postby GarethB » Sun 15 Feb 2009 2:30 pm

Andrew,

I wonder if part the problem is oxygen transfer through two layers of lenses as you have grafts. What you describe the warm feeling is one of the sensations i get just before odema sets in. This was the problem I had with the Kerasoft 2 lenses and the initial K3 lens. It was a concern of the hospital when i first suggested soft lenses to them.

Since the K3 lens designe changed prior to its official launch in 2007 I've not had much of a dry eye problem or lack of oxygen either.
Gareth

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Re: Failed to manage with Piggy-Back lenses

Postby rosemary johnson » Sun 15 Feb 2009 10:16 pm

Graeme, thanks for comment. No-one ever said anything about, and I never thought of any problems to do with, hard lens solutions when I started piggybacking.
DOn't htink they've been aproblem, though - whether they would if I'd not been using daily disposables, I don't know.
I starting piggy backing inthe eye that later had the graft that went pear-shaped, and only occasionally now do it in the other eye, so probably not enough cahnce of problems to worry overmuch.
As for solutions making a difference - yeah, tlel me about it. BRING BACK K-LENS!!!!! - yup. I'm one of those old-timers who want my K-Lens back and was devastated when it disappeared off the shelves. Amidose is just not the same!
Fortunately never been prone to dry eye (only once when the organisation I was working for put in new aircon) - and best remedy for me to getting dry is drinking lots of water. Witout that I can dehydrate pretty nastily - but liely to get dehydration migraines before eye troubles.
Rosemary


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