keraflex

[Lynn White]

jhon

I have not seen any patients that revert to glasses after the procedure. That does not mean this cannot happen, but I have not seen this. (Happy to be contradicted by anyone with other experiences!)

The majority I know of are still fluctuating and require contact lenses. However, as this is a very new procedure, I have no long term results available.

If anyone is thinking that this procedure immediately gives good, consistent vision, then they are mistaken. Anyone undergoing KeraFlex with KXL has a double whammy... the KeraFlex causes selective scarring which is intended to reshape the cornea. This in itself suggests that there will be some vision fluctuation as the scarring settles.

Additionally, KXL is an accelerated form of CXL which has not yet been validated. CXL itself causes fluctuations in vision over a period of at least 6 months. And as improvements take place over years, this procedure, by definition, is not immediately stable.

Therefore we will not know for several years whether KeraFlex+ KXL actually works.

To be honest here, I have not seen any really good results from this procedure yet. This may well be because it takes a while for good results to come through. With my CXL patients, I am now seeing some really excellent results 3 years post CXL, especially for those wearing any kind of contact lens.

However, I have seen enough (and heard reports enough) to feel that KeraFlex will not give you instant, improved vision. Many regress and the resultant scarring is significant, although does not always impact on vision.

This is entirely my own view based on cases I have seen or discussed with other professionals.

I am completely open to discussion with professionals who have experiences contrary to mine, either here or offline.

Lynn

[Luciano]

Yes lynn. The vision dont get better fast as we want. Today is my 21th day after surgiry. Yesterday doctor could see the Ring made with keraflex. I have two questions: is normal the ring have a little opacity while its recovring? I thing its the area was burned. After a while the scars will desapear? Or not? If not what kind of trouble can brings to you. So, with how many days people who did keraflex Nd kxl can see better without contact lenses? Do you know if the have a problem with focus and read after procedure? I feel i can see much better during the day because the pupil is in the RING. but at night or with no much light be very bad. Also do you have a good results after a procedure with soft cl's or still hard? Whit kind of soft do you recommend. Thanks a lot

[Luciano]

Hey kas where didi you tryed to do the keraflex? Wich doctor when? Thanks

[Lynn White]

Luciano,

The KeraFlex procedure is based on the assumption that the microwaves do cause a lesion (scar). Here is a quote from Arthur Cummings in a recent article: "In this treatment, a low-energy microwave pulse is applied to the cornea to shrink corneal collagen and form a toroidal lesion in the upper 150 μm of the stroma.". Thus, if you are asking how long this will take to fade, it is not likely to do so quickly and it is still present several months later in patients I have seen.

As to what kind of trouble it will bring you, this depends on where it is. If it is outside your pupil area, its unlikely to bother you, If its within your pupil area then it may do.

The full article can be downloaded here where the scar from the KeraFlex procedure can be seen.

Additionally, when assessing the procedure from articles such as this, there are some important things to consider:

1) They are meant for professionals so that when there are discussions about "corneal flattening", this does not necessarily equate to vision without glasses. It is talking about effect on corneal shape, not visual acuity. Good vision relies on many factors, not just how flat your front corneal surface has become.

2) The changes in corneal shape are shown over a period of 6 months - but not what happens day to day, so it is difficult to gauge what these effects are.

Note also from this article that "If CXL is delayed by a few days, approximately 6.00 to 8.00 D of regression occurs between procedures." i.e. if KeraFlex is not done with CXL or KXL at the same time, then the cornea starts to regress. Therefore the effect is reliant on cross linking to hold it.

The question remains: is CXL or KXL enough to hold this amount of corneal shape change in place? And for how long?

This cannot yet be answered as we do not have enough cases followed up over a long enough period of time. Remember - CXL has been around for years now and it is still considered as "experimental" by many sources.

Lynn

[Luciano]

Today is my 29 day after keraflex. I could read a car plate at 20 meters. First time in life. Vision is not good yet but seems that is getting better. I did a topografy today and there is some high points ( much higher than before) and a lot of lower. But the high points are in different points than before. I hope these points will desapear after a while. Some ponts increased a lot, like 70, and before mqx was 54, but in general is much better i think. Anyone can tell me with how many days corne tends to be good?

[Luciano]

Lynn do you think after a month is possible use contact lenses ? Is it helps to get better?

[Lynn White]

Hi Luciano,

Yes I think it is ....however, I would advise a soft lens as anything more rigid than that might well alter the corneal shape. I would normally look at a disposable to get some vision back at this point while things are settling down. It can act as a bandage lens and give you some balanced vision while things are still settling

Lynn

[drink]

Some fantastic information on this thread, many many many thanks to Lynn for some quality replies :salut:. Extremely helpful, so much respect for your help!!!

I have been considering KXL keraflex for a while now, but reading into it more and more, I was convinced i wanted to have KXL done, but now its making me think twice. Like Lynn has mentioned, there are alot of things to consider and keraflex hasnt been around for that long. It would be best for patients to have consultations carried out and see whats best treatment for them and for their condition and situation etc.

LUCIANO: please keep the updates coming, very interested in knowing your progress!!! well done as yours seem to be heading int he right direction!

[Luciano]

So, today i went to the doctor again. And my topography changed a looot again. i really dont know what should i expect. But i drove whithout glasses or cl. Vision left eye become more stable, rigth the center increase a lot. The doctor said it could be the process of cure. So at least it can be better. But not yet. Degree still high at machine. Its a little strange i can drive but i cant read well. Now i just know you have to be very very pacient for the results . Today its my 6 th week. And Im at home for this period without working. I think people need consider every period you shold be out of live. Now i can do a lot of thinks in the morning but at night vision stil bad. Lets wait 1 more month to see whats is going on. Regards for every body. Lynn i want ask how many weeks later your pacients achieved a good vision with soft cl and the stabilization. Did you see any big changing also, like in few wekks vision improved a lot or ger worse a lot. What do you think i should do? Usu soft cl for 3 months and see the results?

[Lynn White]

Luciano,

Its almost impossible to say because everyone is different. This is why it is so difficult to advise about post KeraFlex as there is simply not enough information to generalise. Some patients started off seeing well and then it went off after a few months and with others its the other way around.

If you cant read well, then I would guess that your vision has over corrected a bit, which would make it better further away than near. However, your own doctor could advise you better than I about that.

Soft CLs would be a good idea for 3 months, as rigid lenses may not cope with the fluctuating shape as well as soft ones (which flex).

In general
Certainly, fluctuating vision is the key thing to consider with this procedure. As you can see from people reporting back, if you have both eyes done at the same time and you fluctuate a lot, then you are putting work at risk.

Lynn