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Post Info TOPIC: Dominics PRK and crosslinking story


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Date: Wed Oct 29 6:14 AM, 2008
RE: Dominics PRK and crosslinking story
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If my keratoconus was still in early stages I most likley would have seen dr.stein here in canada.I am actually going to see him tomorrow for a follow up. the reason I went to Europe was because with Dr.K's treatment, thr prk normalizes the cornea so it gives it a better shape for the crosslinking. The prk dr.k does is different than a standard prk. It is a limited topogrophy guided prk that removes no more than 50 microns of tissue. The reason for the laser is not like most where it is fixing the refractive error, it just makes the cornea more cemetrical for the crosslinking.

I still have much haze in my right eye as well. I spoke with Dr,K today because I was worried about my vision. It is way worse now than before the procedure. 20/70 in left and barely 20/200 in right. Before op i was 20/20 and 20/30. Dr.k explained to me that these procedures do take time, will probably have good results at around the 2 month point. I know that Dr.stein has the most experirnce in Canada for crosslinking. Has your Keratoconus stabalized?

The haze can last up to 3 months, even longer I believe. Dry eyes is common from alot of people I have spoken with. Especially after finishing using the prescribed drops.

Yes the prk does give you your vision back, but it depends at what stage your kc is, mainly the thickness of your corneas. Because you had your procedure done at Bochner You are definatley over 400um, because I know they do not preform the procedure below that. You can still have the limited prk after crosslinking. The reason Dr.k does them sequentialy is because the prk can take away from the crosslinking after. He has done many studies and the groups that had procedure done at the same time did better in all fields.(acuity, regression and so on...)

-- Edited by pereira951 at 07:22, 2008-10-29

-- Edited by pereira951 at 13:22, 2008-10-29

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Date: Thu Oct 30 11:43 PM, 2008
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Day 21.. saw Dr.Stein today. Says my corneas are nice and clear. My vision is still horrible though, could not read anything on the board. But when he put a chekered thing in front of my eyes I could read almost every line. What is this thing?Also my ocular presure was high, they called it borderline and cut my maxidex drops in half and put me on another drop called duotrav to lower pressure. Still a little peeved that I flew half way around the world for an operation and I was not even told that I should be having my eye pressure tested while on the maxidex.(good thing I do alot of my own research)Is this high ocular pressure something I should worry about?or will these new drops take care of the problem?vision in right eye seems to be getting worse before it gets better. Just being patient as thats all that I can do. The halos around lights also seem to be getting bigger and changing shapes slightly. Sorry about any typos, can not make out a single thing close or far with the right eye and the left was really clear reading before but starting to get a little blurry.My next appointment with Dr.Stein is December 11. Will post any major changes between now and then. Dr.K told me I should start seeing results at the two month point. As I said after the slit lamp evaluation today corneas seem to look well. Too early to take any measurments.

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Date: Fri Oct 31 12:27 AM, 2008
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Hello Dominic.

If i were you I would call to Dr.K to ask about the new drops.Pay attention.Perhaps the high pressure you are mentioning is causing it from the corneal density.This happens after the crosslinking.How did Dr Einstein measure your pressure?Is it IOP Goldmann?Because i am the oldest patient in this treatment i happen to know some details that it is difficult to measure the eye pressure after crosslinking because you have also lower thickness to size.

Be sure about the drops.Dr K must know something more mate.Dont jump into conclusions.You will be amazed about your vision.I think it will be so crisp as that checkered thing you mention looking through it like a pinhole.

Also from my experience(I am the oldest one in here who has done this combined treatment) maxidex drops can cause you problem after the 60 days period.Thats why if you read dr K instructions which has provided you that you are going to use it for this period and thats why Dr K wants you to go at 30days post operation.This is standard procedure.

It is important not to put your hands and touch your eyes or worse rub them.These habbits are forbitten for us kcers.So be advise to ask him if you are changing the drops because you changing the protocole of healing and there is the risk of infection which you do not want to have it at this point of fragile time.

Takecare,

P.S Excuse me for my english.

-- Edited by Zeus at 01:29, 2008-10-31

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Date: Fri Oct 31 1:30 AM, 2008
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will contact Dr.k tomorrow but dr.Stein also preforms crosslinking. that is why I went to him for my post op. Dr.Stein has the most experience in Canada with the crosslinking. Dr.k has me on the maxidex for 4 weeks four drops a day, and 4 weeks two drops a day. I am sure an increase in pressure is bad no matter what because any damage done to the optic nerve is irreversable. I am only being cut short from the four drops a day for 1 week, and will be sure to email dr.k right now to find out if i should be taking these drops.

Thank you for your quixk reply zeus.

-- Edited by pereira951 at 04:34, 2008-10-31

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Date: Fri Oct 31 6:52 PM, 2008
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I have also had this treatment here in Greece with dr. Kanellopoulos and I also had an increased IOP so the dr gave me some Lotemax drops for a month after stopping maxidex drops. So, it is better that you ask him like Zeus said.
I think this increase in pressure is common in these operations, mostly because of the steroids but I don't know what kind of increase is normal.

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Date: Fri Oct 31 9:12 PM, 2008
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Dr.k just emailed me back.Told me to stay on the regimen of maxidex but to take the timolol with it. When I called this morning the nurse there told me to take the duotrac as subscribed by dr.stein, but in dr.k's email it told me to take timolol 0.5% twice daily. This is one of the ingredients in the duo trac. So now I don't know wether to take the duotrac once or twice daily, just waiting for dr.k's response. IOC is common while taking steroids for the eye,,,,,but must be monitored, From research I havr done, optic nerve damage is irreversable.

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Date: Sat Nov 1 3:16 PM, 2008
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Wait for the doctor's reply but if I were you I would at least take duotrac once until I get an answer.
Best wishes

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Date: Sun Nov 2 3:48 PM, 2008
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Last message from Dr.k was, duotrac is probably better, dr.stein is very experienced and will be able to monitor properly.

This was still an unclear message for what proportions to take drops. I have split the drops between both doctors untill I get a clear awnser from dr.k. I take 3 drops daily of maxidex and 1 drop of duotrac every 18 hours so it works out to 3 drops ecery two days.

Today is day 24.....Vision is extremely blurry in the right eye.More than in the last 8-10 days. It feels very itchy and slight pain, almost like pressure but more of like a headache behind that eye. Just feels scratchy in the front. Headache is most likley from such difference in vision in both eyes. Could not even see my eye chart even existed on the wall today with that eye. Still roughly 20/70 with the left.

Left changes daily, some days really clearing up, some days little blurry, but changes from morning to night.

Will call dr.K directly if I do not here a message from him by tomorrow in regards to drops, but have appointment with my regular opthamolagist wed. Will check pressure than.

It is quite intersting to see what happens as the cornea changes shape. Every day in my eyes, the ghosting changes. The left is sometimes up, sometimes down. The right is always extremely up and down, but more so one way than the other as days progress.

In comparisson to the first week after surgery the left eye is crystal clear:)
The right will follow in the following weeks I am sure.

My last message to dr.K did explain what I was doing with the drops by splitting them between both doctors. Will probably put 4 drops of maxidex today again. Hopefully Dr.k will message me back soon.

My 30 day point is soon and that is when I drop to the two drops daily.I still wear my face shields every day when I sleep because I am afraid that I am an extreme eye rubber in my sleep.

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