Questions.

[Anne B]

Hi all,

Can anyone answer these questions for me.

1. What are Intacs?
2. What results can you expect with Intacs?
3. Are C3R and Intacs only avaliable privately
and if so why?
4. If i was to have C3R or Intacs where would i stand with follow up treatment at Moorfields?


Thanks Anne

[jayuk]

Anne

To answer your questions

1. What are Intacs?

Small semi-circular plastic material which are inserted into / underneath the top layers of the Cornea, with the intention of changing the corneal shape thus allowing for a better fit with contact lenses.

Please see http://intacsforkeratoconus.com/main/

2. What results can you expect with Intacs?

Depends who is doing this in all honesty. Only a very few in the world that have mastered this art! And sadly he is in Mexico!

Results vary, but an underlying issue are the effects on the cornea and the intacs when/whilst the KC progresses. (although Intacs ARE reversible)


3. Are C3R and Intacs only avaliable privately
and if so why?

I believe Intacs are now available on the NHS in some Eye Hospitals / Units. C3R still required clearance by the respective medical authorities and thus any instances of treatment with C3R are merely for research / trial reasons.


4. If i was to have C3R or Intacs where would i stand with follow up treatment at Moorfields?

Well your follow up treatments would be the the people/hospital which performed the procedure. Moorefields can/would still fit you with lenses etc. However, do bear in mind that the cornea would change shape with C3R/Intacs and thus you would need to wait a while before having a Contact Lens re-fit

Hope that helps

Jay

[Anne B]

Hi
Thanks for that. two more question.

Why have C3R and Intacs never been mentioned at hospital visits? Are they frowned upon?

Anne

[jayuk]

Anne

Where do I start lol....

There are a number of reasons why this particular treatment has not been progressed as aggresively as others.....and it boils down to the current treatments and options within the Opthalmic community.

Eye Units / Eye Hospitals do not want to take on the risk of trying something so new (6 years is still new in Medical Treatment) and so many wait on results and trials. The issue here is that up untill December there were only around 5-8 sets of people Globally that were even looking at this treatment. I am now led to beleive that in Europe this has increased and many are starting their own trials in various ways.

I would suspect that Moorefields may have this available within 3 years IF its passed and if someone their takes on responsibility in introducing and developing the treatment.

Until this happens (and as much as it sounds crazy! Moorefields still does have alot of Clout in UK and Europe in terms of emerging treatments) we have to rely on the Private Consultants whom can deliver the treatment.

J

[Anne B]

J
Thanks very much for your help. Can i ask another question sorry to be a pain!

If i had C3R and it wasn't successful could i then go on to have a graft.Also, would the same apply with Intacs.

Anne

[jayuk]

Anne

I assure you, you are not being a pain

Yes you can have a graft after C3R. This is the same route I shall be taking. I had the C3R done on my left eye to stop its progression as I had a very strong feeling that it was heading to a Hydrop! If that happened than I would have needed a full penetrating graft...........however, since having the treatment the KC in the eye has halted and I shall now be having a DALK (partial graft) this year....

Same applies to the Intacs also.....they are reversible and thus are taken out prior / during the graft procedure

J

[Susan Bourg]

I'm new to this so I'm not sure I'm responding to the right post. I want to know what is the graft procedure? My son just had intacs put in his eye and he is considering the C3R as well. He's apprehensive b/c C3R is new and he worried that it could harm him later down the road. any suggestions???

[Andrew MacLean]

Susan

There are two graft procedures. The commonest is sometimes called 'penetrative' keratoplasty (PK)

they take away the full cornea from the host eye and graft the cornea from a donor into the vacated place. this procedure has been offered for over a century. I had a PK in my right eye in December 2003, and after about two years I got good sight from the graft.

The second is DALK. for this they take away the diseased part of the cornea and leave part of the host cornea in place. They then graft a partial thickness cornea from a donor onto the host's own "endothelium" (the back bit of the host cornea).

The advantages of DALK is that there seems to be virtually no risk of reection. The disadvantage may be a longer recovery period.

I am sure that your son went through the normal stages before Intacs surgery. C3R has been covered by Jay.

There are risks involved in any surgical procedure. I decided as a young man that I'd wait until I had nothing left to lose before I accepted any surgery on my eye. for many KC sufferers that time never comes

All the best

Andrew