Hard Lens Use Post Graft

[matty04]

Hi folks, kind of a similar situation to a recent thread by Joanne Poultney but i would appreciate some feedback on my own situ please .......25 months after i had my second graft & about 7 months since having astigmatic keratotomy i am now being given a hard lens to wear in a couple of weeks. I have made the hospital optician aware that i am not keen on going back to wearing a hard lens after suffering years of problems with them & that my consultant had previously mentioned the possibility of further surgery in an attempt to improve my vision.

I would just like to know if anyone here has experience of returning to hard lens use after a graft and how you get on? i am not due to see my consultant prior to lens fitting but wondered if i should try and speak to him to voice my concerns? Cheers

Matt

[Andrew MacLean]

Matt

Pre graft I couldn't wear my RGP lens, or any other sort of lens for that matter.

Post Graft, my eye is a better shape to accommodate a lens. I need both one lens and glasses to provide the best correction to to allow each eye to see a similar sized image to the other. My lens comfort is now pretty good, and i am back to an RGP corneal lens.

Andrew

[GrandPaClanger]

Hi Matt

I am going for a lens fitting tomorrow (14 post graft) . I'll let you know how it goes. I know he is trying a RGP Any particular concerns you have ?

Ian

[matty04]

Thanks Andrew, i guess if it works then thats great and it's good to hear you cope well with yours now. I will also be wearing glasses for my right eye but i guess if things went well i could possibly move back lenses for both....although the thought doesn't fill me with joy

The optometrist tried a soft lens in my left which felt ok but he also tried one in my right eye which i had a graft 10+ years ago and it was very uncomfortable he had to take it out....so that didn't help either

[matty04]

Hi Matt

I am going for a lens fitting tomorrow (14 post graft) . I'll let you know how it goes. I know he is trying a RGP Any particular concerns you have ?

Ian

Hi Ian, good luck tomorrow my concerns generally are based on my previous experiences pre-graft which were tough to cope with, finally ending with corneal ulcers. I know the the reason for this was due to the advacnced KC and my cornea is now (hopefully) in a better state to handle the RGP but i can't help feeling i'd rather not go back to contacts

Matt

[longhoc]

Hi Matt, yes, ditto, am in a similar position (or might be when my stitches come out at the end of the week) -- what to do about any residual refractive error post-graft.

One thing I read which did give me a bit of cause for optimism is this:

http://www.healio.com/ophthalmology/ref ... eratoconus

Now, before I get too carried away, this study did suffer from the usual "Keratoconus research failings" of a) a very small sample sizes and b) really not long enough follow-up time. But like you, I'm loathed to go back to an RGP in my grafted eye, should this be necessary. I'm going to investigate if soft lenses might be an option. Not something I've really looked into, as it's not been applicable until recently, but I'll check it out. If you're interested, I'll post the conclusions.

Best wishes, hope things go okay for you (you too Ian).

Chris

[GarethB]

My situation was very different as I didn't need lenses post graft for 16 years, but when I did get them, within a couple of years I had become sensitised to the RGP lens and it was having a negative effect on the graft.

Now using soft lenses for KC and things have never been better, so good in gact I can't even feel the lenses and wear them all day every day, in fact the first thing I do in the morning is put my lenses in adn the last thing I do at night is to take them out.

All the optomotrists I have come across have said fitting a grafted eye is just as hard if not harder than fitting a KC eye. They have to consider the lens fit on the graft, makes sure the is no rubbing of the lens on the graft margin and make sure the edges fit correctly over the host cornea. They often say it is like getting one lens to fit three eyes all at the same time.

So if you're worried about RGP lenses, in your position I would push to try the soft lenses first. If the lenses I have now were available in 2004 I would have gone down that route rather than 4 years of pain and discomfort with RGP lenses.

[Anne Klepacz]

As ever, we're all different. I found rgps agony to wear in the couple of years before my grafts. Post graft, I went back to rgps and have worn them ever since (around 25 years) and have found the comfort hugely greater than pre graft. But of course, there are now many more lens types to choose from. So if rgps are still a problem for you, there are a number of other options you can try - the special soft lenses Gareth mentions, hybrid lenses, scleral and semi scleral lenses and piggy backing. Good luck, and let us know how you get on.
Anne

[GrandPaClanger]

Had my appointment this morning and it went better than I thought. Managed to come away with a glasses prescription, which is a major result. This gives me 6/9 in both eyes (with a balancing lens for the left eye which will still need the contact).

Then the fun began with the lens fitting. Must say I was a bit nervous when the moment came to drop the lens in. Gripped the chair hard in preparation even though I have worn hard lenses 32/50th of my life. Tried a few variants in size but ended up with a 11mm diameter RGP that gave me 20/20 so I’ll take that . Didn’t feel to bad I knew it was in there but it started to settle down so hopefully I will get accustomed to it. Asked about other options but it does seem to be that RGP are the first weapon of choice. They said that there could be issues for me with a soft lens because of the amount of drops I am on for the inter ocular pressure. The preservatives are not good for soft lenses. They also mentioned that there is a higher risk of infection with soft lenses, again not good but defiantly not good for a graft.

Hopefully being a bigger diameter it will keep a bit more dust out and be a bit more comfortable. Next appointment on the 5th September to collect the lens. Hopefully they get a cancellation and get me in before then but not holding my breath.

Ian

[GarethB]

A study done by Sunderland university took data from many eye casualty units and yes soft lenses carry a higher infection rate. I contacted the author and none of those were for people with KC, they all involved people who wear soft lenses because they don't like wearing glasses. At KC confrences, BCLA confrences, the Dutch equivelant and at contact lebns fitting workshops I have asked optomotrists and opthalmologists if they have encountered people wearing soft lenses for KC developing eye infections more than RGP wearers and to date none of them have.

As far as I am aware about half the soft lenses on the market for KC are three monthly disposables so there may be a good chance that a lens would be reoplaced before eye drop preservatives bacame an issue.

This is just based on my expereince o combined with that of others here, hopefully the information will be taken as a whole so people can make a balanced informed choice.

Unfortunatly for me, RGP's on a graft that was 15 years old did start to damage the cornea after 4 years of use despite the best fit the hospital could get, luckily the graft recovered with soft lenses and now been on those for 4 years and in both the case of RGP and soft lenses no eye infections.

I will of had my right graft for 23 years in two weeks from today and the left for 22 years in three weeks on Friday.

What is often overlooked by opthalmologists and optometrists is that people like us with amedical need for contact lenses do take more care regarding eye hygiene and lookinga fter their lenses because without them we are often legally blind. Unlike those wearing lenses for vanity purposes who I have encountered and have said, there I have taken my glasses off, am I legally blind now? There have been times I have threatened to smash their glasses before saying Yes! Yes you are now legally blind until Specsavers opens in the morning!

Anyways, good to know you get good vision with glasses, by the time I was five years post graft the glasses prescription had reduced to the point I went the next five years or so with no need for vision correction.