Lasek after Intacs?

[ce2-batson]

Hi, this is my first topic post although I have been checking out this site and all your great advice for the last few months.

I was diagnosed with KC here in Dubai 4 months ago and went ahead with intacs surgery 1 month later. I just had my 3 month checkup and the Dr is pleased with things and with the stability of the prescription, as am i - my vision has improved and the blurriness I had post-op has disappeared.

Now we are discussing the possibility of me having LASEK in another 3 months. He told me that my vision would be substantially improved but that it is alot more painful than intacs surgery (I found that pretty painful) and that the recovery time is longer. I am contact lens intolerant so I don't have that option available to me.

Has anyone else out there had LASEK after intacs? Or indeed had LASEK and can share their experience? I read some posts that LASEK is not recommended for KC patients as it thins the cornea, but the doctor said in my case I have a relatively good cornea for someone with KC, and a small refractive error so I am the perfect candidate. The amount of cornea he would have to remove is pretty small.

Would appreciate all your experience and opinions

[GarethB]

Welcome to the forum.

We do have some people who have had Lasek but as far as I am aware, they joined the forum as they developed KC post Lasek.

When I was having vision problems in 2004 I enquired about laser surgery and my consultant said as I had KC, as far as he was concerned it was more likley to make the KC worse. A sentiment echoed my other consultants that have been asked this question at some of our group meetings in the UK.

Your consultant may well have different information which is why he feels this might be appropriate for you, after all there have been many occassions where one medical study says a particular food is good for you just for another study a week later saying the same thing is extremely bad. It becomes very hard for us to know who is right.

I think we all would be interested in any further information your consultant could provide regarding this matter.

What type of contact lenses have you tried?

I only ask because lat summer I started to have problems with my RGP lenses, similar to an incident in 2005 and it was suggested I had become sensitised to the RGP material. I am now using a silicone hydrogel contact lens and things are much improved far beyond the change in RGP material I had from the hospital which did help a bit.

[Andrew MacLean]

ce2

Welcome to the forum! And, welcome to your first string!

Well done with your progress following your INTACS insertion.

There is no way of knowing how much thinner your cornea will become as a result of keratoconus. Your surgeon seems quite sanguine about the prognosis, but the decision about whether to have laser surgery is yours. I guess you have to decide now what your response would be if, at a later date, you found that your KC was progressing and your artificially thinned corneas brought forward the day when you might need a transplant.

If you are relaxed about future surgery, then you may make one decision; if you are not, then your decision is likely to be different.

All the best

Andrew

[ce2-batson]

Thanks to you both for your messages.

I have tried all sorts of contact lenses - the problem is that they seem to rotate on my eye as the cornea is so 'steep' and to be honest the whole experience was so traumatic and painful that I can't face trying it again at the moment.

It is interesting that there are people on here who developed KC after having LASEK, i should definitely ask my doctor about that. When I asked him whether it would impact my KC he said yes of course, but he said on balance it is still a very positive thing for me. I may go and see someone at Moorfields in the UK just to get a second opinion as unlike intacs, LASEK is not reversible and this is a big decision.

I would still be very interested in anyones experience of LASEK surgery and the post op recovery.

Thanks once again

[pepepepe]

Ask aroundf as opinion varies and its knowedge and experience that counts

Is there post laser induced KC people here ?? I haven't read any posts from anyone such.

[Lynn White]

Hi Ce2

I am a KC professional... in that I fit contact lenses to patients with KC, Post CXL, Post INTACS....and post lasek ectasia (KC) I am afraid the latter is a real issue, though you won't hear about in mainstream surgery information.

As in, there are people who, even though they have completely normal corneas, have lasek and go on to develop KC several years later. ANY thinning of the cornea puts ANYONE at risk of future KC. Thing is, we don't know the risk stats yet.

So to have laser after INTACS??? To be honest, the long term effects of INTACS are not yet known never mind the effects of INTACS plus laser. INTACS itself has a measurable track record but as far as the combination is concerned. the jury is still out.

Myself, if my family was involved (and I DO have keratoconic family) I would say ... wait.

I can see the allure.. the tweaking that lasek can provide. But I also see many previously normals who have lasek and end up KC. More time is needed to be sure.

Lynn

[Andrew MacLean]

In spite of a number of warnings, pepe continued to send posts that were personally insulting of other users.

His posts have been removed and has been suspended.

Andrew MacLean

[ce2-batson]

Hi Ce2

I am a KC professional... in that I fit contact lenses to patients with KC, Post CXL, Post INTACS....and post lasek ectasia (KC) I am afraid the latter is a real issue, though you won't hear about in mainstream surgery information.

As in, there are people who, even though they have completely normal corneas, have lasek and go on to develop KC several years later. ANY thinning of the cornea puts ANYONE at risk of future KC. Thing is, we don't know the risk stats yet.

So to have laser after INTACS??? To be honest, the long term effects of INTACS are not yet known never mind the effects of INTACS plus laser. INTACS itself has a measurable track record but as far as the combination is concerned. the jury is still out.

Myself, if my family was involved (and I DO have keratoconic family) I would say ... wait.

I can see the allure.. the tweaking that lasek can provide. But I also see many previously normals who have lasek and end up KC. More time is needed to be sure.

Lynn

Thanks Lynn, good advice no doubt. I did find a research paper on this and am waiting for them to send it me. The summary of the conclusion provided suggested positive outcomes, I will try and post it here when I receive it.

[ce2-batson]

Oh and also I was doing some research into the actual post-op effects last night. Sounds horrific! One woman said she wanted to take her eyes out it hurt that much. I am not sure I am prepared for that, especially if the success is not guaranteed......

[Dubai Gal]

ce2-batson, do you mind if I ask which Dr. you are seeing here? I am also in Dubai, I have not had intacs but have had CXL in my right eye and has been great in reducing the 'cone' so far (except the refractory error is the same) and am looking at going ahead with some kind of laser surger to correct the refractory error.. I have spoken with 2 Drs here so far. I am waiting for a final answer whether the general consensus is to go ahead with lasers as it is a risk and they would not be able to correct my -7 error (my current eye doctor was evasive on the subject) I have also decided to go to two other clinics in, one in UK- Accuvision. on in Ireland - Wellington or something I think so I can get an all round evaluation from people who do this type of surgery before I make my choice (or get told it is a no go). Would be interested to know who you are seeing to get yet another opinion, lol!

Your experience with contacts sounds similar to mine, I HATE them they cause my eye so much pain and irritation and can cause scarring etc so I have said I am not trying RGPs any more. I am going to give Kerasoft and Soft K a go.