Piggybacking, soft lens options

[GarethB]

Hi Chrism,

Pardon my ignorance, but hod do lenses rub on the intacs which are embedded within the cornea?

The presentation I attended on intacs showed how the tunnel for the intacs were made. Does this leave a highh point where the intacs are?

[Sweet]

Gareth that is a good point and one that i would like to know about as well!!

I couldn't live without piggy backing lenses, it is so much better! The only problem i have is that my lenses do tend to get foggy after a while and i have to take them out and clean them but then it is all ok.

Ivoryhunter - i hope that you find something soon to help with your vision. Best of luck with it!

Sweet X x X

[IH]

Hi Sweet thanks,

My appointment is later in January to get this issue sorted out. I have actually resorted to wearing my RGP's without the soft lenses and appear to be coping fairly well (with lots of eye drops though).

I expect once I have my appointment with a new KC lens fitter I will hopefully

1. Get a better (maybe thicker) piggyback lens
2. Move to a 'softperm' type lens

Andrew mentioned in another post somewhere recently something that I hadn't given much consideration to. When I first "piggybacked" it was with new lenses (it had been about 2 years since I had new lenses) so I never felt what it was like (until now) without the soft ones in. It's like I am getting used to RGPs all over again, but maybe the fit is just better for my current condition.

I believe in theory that the piggyback is the way to go if I have to have RGPs

Anyhow, I am still 100%^ committed this year to getting the best fit with most comfort!

Cheers

[chrism]

The INTACS are embedded within the cornea, true, but my Drs. do not want to fit me with lenses where the edge of the lens would be directly over (or a portion of the lens could rub directly on) the INTACS . The tissue is much thinner directly over the INTACS and excessive rubbing could cause serious problems. Plus, i believe the tissue directly above the INTACS is raised very slightly due to the added volume of the implants below. It sure seems like i feel them with my finger tips when I take my soft lens out.

Basically, they have tried using lenses that either stay within the area bounded by the INTACS or to vault over them.

[GarethB]

Thanks for that, it makes sense now.

So making the chanel not so much 'bores' a hole, but splits the layers so the corneal thickness you have pre-intacs plus intac thickness make slight ridge over the intacs.

The presenattion I saw made it look like there was a tunnel for the ntacs and no ridge left.

Having had grafts I understand why they do not like lenses rubbing. Having said that in my right eye the old cornea the graft is attached to has deveolped KC and there is no choice but to have a lens rub where the graft margin is otherwise the KC could not be corrected. Been wearing lenses on that eye for 2 years now and the graft is about 20 years old and i have had absolutly no problems at all.

Is it just the RGP lenses you have tried or have you tries some of the soft lenses especially for KC?

Just thinking if the soft ones work they might not agrevate where they might overlap the intacs.

[chrism]

We tried RGPs primarily. A standard one first, followed by the intra-limbal. We then moved to the piggyback after neither offered adequate comfort.

I researched many of the soft lens options and presented them to my OD but none would work for my level of KC or in the case of the softperm and synergeyes KC lens, the INTACS would be in the way.

The KC in that eye was far enough along that the primary goal of the INTACS was to delay/prevent a graft as long as possible. We had no expectations for an improvement in my visual acuity. Comfort levels were mostly unchanged with the INTACS though my OD claims that fitting lenses was somewhat easier due to the flattening of my cornea.

I wear a Softperm in my right eye (no INTACS). I hope to change to Synergeyes due to the improved oxygen permeability and supposedly better durability.

[GarethB]

I am trying Kerasoft at the moment which is a wholy soft lens.

The test fit we got 20/20 in each eye which was un expected as the level of KC in the right eye is beyond what a Kerasoft would normally be used for.

The lenses that were made are not quire right, but hopefully the next set will give 20/20 in the right eye which is the worst. For some reason the left eye does not want to play. However we are confident that should a third fitting be necessary that we could get the 20/20 I need to reagin my motor sport race licence.

I have found some optoms go by what they have been told and the only way to understand the limits of technology is to push it further. When I was told Kerasoft in theory were not suitable I asked what about in practice? Well there was no answer as it had not been tried, so now we are trying ad although the first set of lenses are not as we hoped, there is a strong implication that we can make steps forward and achieve our goal which theretically is/was not possible!