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Post Info TOPIC: Your opions, Haze problems, CXL with rather minor KC?


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Date: Tue Feb 17 9:35 PM, 2009
Your opions, Haze problems, CXL with rather minor KC?
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Hi, i have been reading here for some hours, i am scheduled for an epi off x-link (the first in the region, southern part of Sweden) in some weeks hopefully. I have KC on both Eyes, the worst in late stage 2 close or slightly below 400um. The doctor said not to worry a solution exist to marginally thicken the cornea during the procedure.

The other eye is still correctable with glasses, (however in last months i started to see some glares from lights) but still i get close to normal eye sight with glasses.

My doctor and i decided that we shall start with the worst eye which i use a Rose-k on and achieve like 60-70% sight with some glares and flares and the usual problems with contrasts. My hope here is to maybe decrease the flares and light problems and increase the sight and reduce wearing problems, and ofcourse prevent further degeneration and need for transplant.

When i read i get scared about the haze, does it prevent you from seeing text on a computer for weeks? How severe is that temporary vision loss?

As i understand most of you recommend doing CXL even on a nearly good eye which has slowly progressing KC, is that understanding correct?

Do you have any opion if the haze is worse or less depening if the KC is in early or late stage? Could a relationship there be seen? ( This would be very useful for our decision about the better eye)

I am a soon 29 years old male btw, who got this diagnose 1.5 year ago it must have been a rapid degenration of the worst eye from good sight with glasses with cyl -2 too bad sight with cyl -6 in like 1-2 years. My concern is that the good eye gets the same problem and now i seek your opions if i should try to stop it on the good eye as quick as possible?

Thankful for all opions about how to proceed, for me it is also the mental issue of every day week or month thinking is it getting worse.

Thankful for all help.

Br Henrik.F






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Date: Wed Feb 18 5:25 PM, 2009
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I don't think that haze will prevent you from reading anything on a computer screen.
Having had cxl, I would recommend performing it as soon as possible BUT if there is a progression, if kc has settled, imho you should wait .

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Date: Wed Feb 18 7:28 PM, 2009
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Thanks for the response, i work as a computer engineer and wonder how much sick leave i must plan :) Do you know if there is any information if the haze is related to servere the KC is?

Yes that was what my doctor said, she saw kc progression in my worst eye and it is close to CXL limit or slightly below so she wants to start with that one.

But in your opinion if there is the slighest kc progression in the good eye i should go for it to? What about using CXL to hope for some regression and ensure to stop it? From the info i have read the risks are very small especially when KC is in early stage? Here since the goverment start to use this as a treatment, cost for the induvidual is no problem. My main issue is the risk of doing a KC eye with stopped or very slow progression ( and also how hard it is to undergo the procedure)

Br Henrik



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Date: Thu Feb 19 12:50 AM, 2009
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Hello,

Just to say that having kc means we have connective tissue problem and less bond crosslinks at the cornea.With other words fragile corneas depending of course the thickness but generally a weak cornea.So,collagen crosslinking is a must for giving strength,many and new bonds,and a better surface(flatter to a point) regarding the stage of kc someone is.

Certainly,it needs time perhaps over a month after the crosslinking for the cornea to settle again but the big picture and the long term thinking is stabilization of the cornea.

All the best,




-- Edited by Zeus at 00:51, 2009-02-19

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Date: Thu Feb 19 10:56 AM, 2009
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Hi thanks for the answer, if KC is stopped naturally is the bonds stronger and the cornea stronger then, or is the only way to make it stronger CXL? Just to doublecheck.

If so i think CXL could be good even in a stopped KC case, or am I doing faulty assumptions?

I mean what to loose? There could even be a slight visiongain, maybe the small KC introduced problems in the better eye even reverse a little as i understand it.

The thing i try to figure out is if i should push for CXL in the "good" eye even if orbscans says it for the moment is stopped or has very slow progress.

For me it is like good and bad eye days, is that normal with KC that the vision can very from days during days, I also feel like bloodsugar and bloodpressure also plays and role in vision, is this bigger in KC eyes?

Thankful for all help, so nice to discuss this issues with people who actually did the procedures.

Br Henrik.F

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Date: Fri Feb 20 1:19 PM, 2009
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Zenke, your Ophthalmologist is the best judge of your situation. However, from what I have read so far ..some of the facts are…

KC occurs in both eyes 90 percent of the cases.
CXL is best suited for candidates who are in the initial stages of KC.
KC progresses at an unknow rate.
Theoretically, your cornea stiffens after 40..some say 45.

You be the judge.

How good is your good eye. Do you know the cornea thickness and curvature readings?


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Date: Fri Feb 20 6:30 PM, 2009
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Hi, its hard to depend how good it is I just quickly saw the orbscan but i can obtain close to 20/20 with spectales, but lately i got some ghosting on it ;(

The doctor said that we take the worst one first because it is close or slightly below 400um limit, this in order to secure it.

About the good eye she said we take it if it gets worse, but hmm if there is close to no risks why not take it to secure it? And the ~80% who reports slight vision correct is also something that would be nice (maybe the ghosting would reduce)

I also have very different sight even during the day and between days, maybe that improves to a more constant level by CXL?

I think the thickness was like 450+ atleast.

I figure about my opions i also read about topo PRK but as i understand it is ok to do topo PRK after CXL too.

Many questions and thoughts :)

Thankful for all answers and opions.

Br Henrik.F


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Date: Sat Feb 21 3:23 PM, 2009
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PRK can be done after CXL, however, there is some corneal tissue removal involved (50 microns i believe) and everyone is not a candidate for it. I think doctors should be very careful in doing PRK on a KC patient considering we don't know the long term results of CXL yet.

I would say monitor your good eye closely and sooner you get CXL done, the better I guess. I chose this path and my astigmatism in good eye did go up by one point, however, I still feel I did the right thing.


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