C3R - Corneal Collagen Crosslinking!

[JMRmail]

I had Intacs and then C3R on my "good" eye without having the epithelium removed.

I had the same procedure done on my "bad" left eye with a corneal thickness of 254. It increased to 369 and Intacs were done on that eye. Please note that my case was highly unusual and I'm not sure too many doctors would attempt it on a cornea that thin, but I was out of options.

I had C3R performed a second time on my bad eye, this time with the epithelium removed. It then thickened to 399.

I have had sensitivity and dryness in that eye, but it is correctable with GP's to 20/20.

[visioncareindia]

CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN (C3R) AVAILABLE AT G.G.S.I.EYE RESEARCH & CURE CENTRE , DELHI,INDIA
Cost in india is about 1000$ where as in london is about 10,000$ to 15000$

The latest revolutionary Keratoconus treatment is C3R (Corneal Collagen Crosslinking with Riboflavin) that has been proven to strengthen the weak corneal structure by increasing collagen crosslinking, which are the natural “anchors” within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular, consequence of advanced Keratoconus.

Keratoconus (ker-ah-to-ko’-nus) means to have a ‘coned-shaped cornea’. It is a relatively common and non-inflammatory progressive disorder whereby the normally round cornea becomes thin and irregularly conically shaped.

Symptoms

In its earliest stages, keratoconus can be difficult to detect as nearsightedness, sensitivity to light, astigmatism and blurred eyesight can occur with the illness. As keratoconus progresses, however, the cornea becomes more distorted and symptoms more apparent. These include:
Blurred vision
Distorted images, especially at distances
Seeing halos of light around objects, especially at night
Sensitivity to glare or light
Disproportionate watering of the eyes

The Procedure

The C3R treatment is performed in just 20 TO 30 minutes. During the treatment, custom-made riboflavin eye drops are applied to the cornea, which is then activated by ultraviolet light
The cornea which is the front transparent structure of the eye is first anaesthetized using drops. . The mucous surface of the cornea (epithelium) is disrupted and then Riboflavin, (Vitamin B2) drops are placed in the eye every few minutes. The yellow pigment of the Riboflavin absorbs the Ultraviolet A light , increases the amount of collagen cross-linking in the cornea and strengthen the cornea.. Once the procedure is completed, a soft bandage contact lens will be placed in the eye and antibiotics will be instilled. The contact lens will be removed in one or two days.

The cornea increases in rigidity soon after the procedure although the process of cross linking continues on for a period of a few days afterwards. The effect on corneal shape takes longer but flattening does not occur in all eyes that have had treatment. A satisfactory result will be arresting the progress of keratoconus.

C3R causes the collagen fibrils to thicken, stiffen, and crosslink & reattach to each other, making the cornea stronger and more stable & halting the progression of the disease

Is Ultraviolet light harmful ?


Ultraviolet A light used in this procedure is not harmful to the eye in measured doses. Ultraviolet C light (in sunlight) is potentially harmful. The Light emitting diodes used in the C3R device is of a wavelength that is not harmful. Furthermore, light emission is carefully measured and calibrated prior to each treatment. There is also a self diagnostic check on the device which prevents use in case of a malfunction. There have been concerns about toxicity to the retina (at the back of the eye) however the Riboflavin pigment in the cornea and front of the eye, absorbs the Ultraviolet light and in effect stops the light from being transmitted to the retina.


Adavantages of C3R

Simple non invasive treatment
Halts the progress and causes some regression
No handling of lenses every day
No stitches
No incisions
Quick recovery

G.G.S.I.EYE RESEARCH & CURE CENTRE

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[visioncareindia]

Intacs can give give good vision but it wont stops corneal thinning,
there are many complications associated with intacs,
corneal opacity, infection, glare,
• Discomfort and/or pain for up to 48 hours following the procedure, which can be treated with medication
• Blurred vision, fluctuating vision, or tearing
• Sensitivity to bright light or glare
• Astigmatism (a temporary blurring or distortion of your vision) for several days after the procedure. This type of visual distortion is normal during the healing process and, in most cases, it decreases overtime. However, in rare instances, it may be permanent.
• Infection, which if severe could result in the loss of the eye
• Corneal edema
• Corneal perforation, which could lead to infection, or, rarely, a cataract
• Decrease in best-corrected visual acuity
• Other procedures may be required to reach the desired result. While there is no guarantee that the goal will be reached with an additional procedure, uncorrected vision may improve.
• Stromal thinning due to shallow placement, which would require removal of the Intacs®

intacs with c3r well not advisable it might break chemical collagen bonds??????

[kabir_5]

Now the package cost for c3r both eyes in london is about 8000pounds

[Andrew MacLean]

kabir

Welcome to the forum.

C3R is available currently under trial at a number of NHS hospitals, so it may be available free to some patients.

Andrew

[Lynn White]

Wow a lot of activity on this thread all of a sudden!

Visioncareindia - I am little confused here. Your post appears to be a straight advert for CXL in India as your link goes straight to Dr Hanspal's website which is also visioncareindia?

On that website, there is also a section on INTACS which does explain the benefits and indeed the whole point of this procedure, which is to make the cornea more regular and to reduce the astigmatism. INTACS do obviously disrupt the cornea, so its balancing the pros and cons here and its by no means successful for everyone but it is for some.

As for your pricing information - this is also confusing as you quote in dollars. Which dollars? Or do you mean pounds?

Generally in the UK, private CXL is around £1200 per eye give or take as every establishment does not charge the same. As Andrew points out, CXL is starting to come on stream here in the UK on the NHS in the form of trials at first and then actual treatments. This does not equate to 10,000 - 15,000 $ or £.

I resume by these posts you are encouraging people to go to India for surgery. Many people do indeed go to India for all sorts of surgery as costs are much less outside the UK.

However, the thorny problem for anyone considering this is the factor of aftercare. If complications arise, then either the patient has to pay privately here for follow up or then turn to the NHS. The problem with THAT is the medical professionals have no idea of what happened during the procedure and little chance of really finding out. I have to also say that if someone only goes over to India for a short period for the operation and then returns almost immediately, I can think of no worse environment for the recently operated eye than a long plane journey with recycled air!

As a caveat - if anyone is considering going abroad for ANY procedure whether it be surgery or contact lenses - and of course, Jayuk who started this original thread went to Dresden for his CXL as it was not available then in the UK - please arrange before you go to have adequate aftercare here in the UK. It is telling that as soon as CXL became available privately here in the UK, Dresden were very reluctant to see any more patients from the UK because of this very issue of aftercare. Finding someone fast to sort you out in an emergency is very difficult.

Visioncareindia - I also note you say as an advantage of CXL - "no handling of lenses?" Can you explain this? CXL does not cause an instant regression. Any improvement is over a long period of time and so certainly if a patient is wearing lenses before the procedure they will need to afterwards. It is extremely misleading to suggest that having CXL will somehow "cure" KC to the extent that people will not need contact lenses. Or do you just mean during the post op period??

Would be interesting to have some real debate rather than a simple cut and paste advertorial?

Lynn

[pally]

Hi,

I have one eye with advanced KC and the other has mild KC. If I wanted to pay for a second opinion as to whether C3R would be suitable for the mild KC, where would be the best place to go in the UK?

I have seen the London Vision Clinic mentioned here.

Thanks in advance.

[Dubai Gal]

pally, I did not have m CXL done in the UK but I did look into it and I was going to go to Accuvision in London. I had my 'moderate' KC eye done first and now I need to have my 'mild' K eye done, has been the best thing I have done in relation to my KC so far. Good luck.

[Graeme Stevenson]

Visioncareindia

I am sure the web master would give you a price if you wish to advertise on the site!
Surely you are not suggesting that sufferers should travel to India for any treatment?
You are also in the very fortunate position of being able to manage your KC with NO aids at all!So your understanding of KC will be very different to most KC sufferers and also the families and eyecare professionals who deal day in and out with the problems caused by KC.

Again back to the main point and that is the merits of Cross Linking.Still not enough data to say one way or the other if that doesnt sound like a real cop out. Having said that I would certainly seriously consider it if I was in the early stages of KC.

[street_spirit]

CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN (C3R) AVAILABLE AT G.G.S.I.EYE RESEARCH & CURE CENTRE , DELHI,INDIA
Cost in india is about 1000$ where as in london is about 10,000$ to 15000$

Didn't cost me that much to get it done in the UK! In Plymouth (Devon) with a very good eye Doctor I had it done for £995 (per eye). In Exeter (also in Devon) they were charging I think £1300 per eye. There are also a number of NHS trials around now as I understand it which would be free. So not sure it works out any cheaper when you cost in accommodation, flights not to mention the added risk of doing what you suggest.