Treatment with laser

[timtim]

I posted a lot if this information in the topic called "corneoplastics", but I wanted to re-post it because I am seeking some advice.

I went to my eye surgeon last Friday, and he told me that he wants to do surgery with a laser on my left eye. He said that my left cornea is about 470 microns thick, and he will have to remove about 25 microns of that to give me the vision he wants. He doesn't feel that this amount of tissue will affect my KC. If it continues to progress, he said that Intacs would be the next step for me down the line.

What he does is shape the outer part of the cornea just slightly with the laser (from what I understand). He has done this on about 25 KC patients in the 5 years he has been doing it, with good results in all cases. He recommended that I contact a few of the patients who had this surgery to speak with them about it, so I am going to try to do that today.

So I am looking for any advice/opinions that you guys have about this to help, as I am in the research and deciding process right now. Do you think it seems like a safe enough thing to do? I will post a link below to an article I found online that seems to be very close to this surgery. Thanks in advance for your help!

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

[timtim]

another article: http://www.escrs.org/eurotimes/August2002/prk.asp

[Andrew MacLean]

tim

'Received wisdom' is that you should not reduce further the structure of an already compromised cornea. Of course there is nothing to guarantee that 'received wisdom' is always right.

What it comes down to is a question, "do you trust your ophthalmologist?" I guess the fact that you have posted your question here already gives at least a partial answer to this question. The truth that you have clearly apprehended is that any choice about the treatment to your eye is your choice alone. Others, like ophthalmologists, can give advice based on their opinion.

In the UK, if we are anxious about the advice given by one ophthalmologist we have an absolute right to seek a second consultant's opinion. This has the advantage of our consulting someone who has examined our eye and who can comment on the basis of medical training and insight.

All the best

Andrew

[timtim]

I have spent the past week or so talking to people who have had the surgery/doctors who have performed it, etc...

What I have gathered is that a good number of people have had good results from it, but there is some risk, since some tissue is removed. One doctor told me that if corneal scarring occurs after the surgery, then a transplant would be needed...kind of scary But he also said that by analyzing my eyes well, the doctor should know whether I am a good candidate or not. I have also learned that some of the effects a few years down the road are unpredictable as well, since it is a fairly new procedure.

It sounds like a thing where I have to learn as much as I can about it, and make sure I feel confident with the doctor's recommendation before I choose to do it.

[clare f]

Although your in the US, im 19 now and had lazer on my left eye when i was 18, it has worked a treat!!! my situation seems very similar to yours, i had a hydrops which scarred over and this scar was central so... my consultant suggested lazer to take the top layer of this scar of so then reducing the thickness and so hopefully better vision. im not going to lie its extremely painful post op but if u get all the right medication then u will b ok, and i didnt have hardly any vision in my eye before the lazer and now i have 2 lines better- they said that was amazing and im very very pleased with it i can now wear a lens again in that eye- i could before because of too much scarring.
so its up to you, but if your eyes are bad then i suppose you try what u can really, i had this lazer as a temporary mesure as i need a graft but dont want one wile im at uni, so this has bought me a bit of time.
hope this helps, good luck!!
Clare

[Pat A]

Hi Timtim
Don't think I'd want to be in your shoes at the moment! It's no easy call.

I actually haven't got KC (although they thought I had originally)- I've got something else. I have had 3 opinions on my problem now and the one thing that they have all said is "don't have laser treatment" - in fact what I have got which gives visual symptoms very similar to KC can actually be caused by having laser treatment - although I haven't!

So I guess I would re-iterate what others have said - you need to trust your optom - and get a second opinion if you aren't sure. They are your eyes, and are very precious and you have to be confident in the people concerned and what treatment is being offered - not easy when you don't have the professional knowledge! All you can hope to do is make an Informed choice, weighing up the pros and cons at the end of the day. I've probably not helped you much but wish you luck in whatever you decide. And let us know ... I am sure everyone here will support you in whatever way they can.

Good luck

[clare f]

I have had 3 opinions on my problem now and the one thing that they have all said is "don't have laser treatment" - in fact what I have got which gives visual symptoms very similar to KC can actually be caused by having laser treatment - although I haven't!

this is interesting because i was never told not to have laser, i think this is mayb because pat doesnt have KC and so obv to have laser shes been told would cause symptoms like it but we have KC so i dont see the problem with causing symptoms like it when we have it. the lazer i had was nothing like the one's always advertised on the t.v. like vision express etc that type of thing to improve. the laser i has was PFK or PTK and it is totally different its a flat lazer,any yes of course because you are reducing the scar you are 'thinning' that certain section of the cornea so also this is mayb why pat was warned off it. When i had my laser i had 3 'goes' in the one session this is as much they could do and keep the cornea thick enough, if you get the right consultant like evryone keeps saying then this should be fine.

Clare

[timtim]

Thanks for all the info and advice on this topic. I have decided to give the Synergeyes KC lenses a try, and put the surgery on hold for now. I was fitted for the lenses yesterday, and pick them up a week from Monday. So I'm gonna see how the lenses work for me, and then either stick with the lenses or explore other options (including considering this surgery more).