keratoconus in Brazil and PRK solutions

[jeronimojera]

Hello everybody,
My name is Jeronimo i´m from Brazil and I have keratoconus in both eyes since i was 20, today i´m 30.
Well, here in Brazil i´ve tried RGPs, soft lenses, Piggy Back lenses, Ferrara ring (wich i removed) and of course glasses.
We´ll as nothing seems to work well and I don´t have the courage to do a graft, a doctor in a city next to mine suggested a PRK for stabilized cases of heratoconus as mine.
I´ve also had talked with a doctor in south africa named Peter Amoils who has perfonrmes a lot of PRK in keratoconus patients with sucess.
my question to you all: What is your opinion in the use of prk for keratoconus, any experience in this matter?
Bests
Jeronimo

[jayuk]

Jeronimo

Welcome to the Forum!

To answer your question, PRK is generally not considered a good solution on KC patients! The general concensus is the after effects of taking out tissue from an already thining cornea MAY be unpredictable

Its been used a number of times on Post-Transplanted cornea to remove high amounts of astigmatism......but not that many on KC affected corneas.....

However, this is NOT to say that it will not work in your case! Alot of variables here such as

a) your level of KC
b) your corneal thickenss

I think it would be a good idea to speak with your consultant on there previous results with other KC affected eyes.

Hope this helps!

J

[Andrew MacLean]

jeronimojera

Welcome to the forum

I was sorry to hear that you have not been able to find a lens that fits. have you tried all available styles of lens and all available materials?

If so, it may well be that the time has come to think about surgery. Do not dismiss altogether the option of a graft. Take advice from your surgeon.

I kept putting off surgery until I had nothing to lose. I figured that if I had already lost my sight before I had a graft and it went wrong I'd not have lost anything, but if it went right I’d have gained everything.

I gained everything.

I do not commend my approach. In retrospect I should probably have gone for the graft as much as ten years earlier than I did, but the decision was mine, and I had to live with the consequences of the decision I took.

All the best

Andrew

[jeronimojera]

Here is the web site of the doctor that performs PRK for keratoconus in South Africa... I´ve been talking with him by e mail.

http://www.eyeworld.org/article.php?sid=484

Tell me what you guys think and if you know anyone who had ectasia after a prk surgery, keratoconus patient or not..

And here is another study with results

Bests

[jayuk]

Jeron

That study was done on patients with mild/mild-moderate KC. If you have this level of KC than as I alluded, this may not be a issue (as the corneal thickness would be greater than that of a Stage 3 or Stage 4 KC sufferer)

Apart from that, its hard to say/recommend anything

J

[jeronimojera]

Well, i, and my 5 doctors (yes 5!!) consider my condition moderate in my worst eye. My worst eye I correct with glasses and get a 20/40 vision and at the thinnest part the orbscan shows 430 micras of thickness. My bad eye is stabilized in the last 5 years.
But my vision is only good to read the chart that has good contrast and brightness.
Well, my biggest question to you all is, do you know anyone who had the prk performed in a keratoconus eye?
Could you ask your doctors of what they think about It? If they know any cases?
Here in Brazil, about 90% of the doctors never heard about the c3r procedure. Here they use the Ferrara Ring most of the times.

thank again for the help of you all
bests
jeronimo

[Andrew MacLean]

Jeronimo

I had thought that the Ferrarra Ring had been abandoned as a treatment for KC, but obviously not in all jurisdictions.

This is a very difficult area. In the end we each have to take the best advice available and make our decisions. All the best with your own quest. Let us know hwat you do and how it works out.

Andrew