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Post Info TOPIC: Opinions on the way forward, orbscans of the "good" eye


Veteran Member

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Posts: 98
Date: Thu Oct 8 5:39 PM, 2009
Opinions on the way forward, orbscans of the "good" eye
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Hi, I need some opinions of what to do, because i have no clue and my eye doctor says wait :)

I post 3 orbsscans of my "good" eye covering half a year, from the orbscans it can be said that KC is pretty stable, I mean changes of 0.1 0.2 D is too little for the eye doctor to do a CXL, since the orbscan seems to vary that much. But i imagine the nightproblems got a little worse, but the cylinder maybe went down a little again.

Would you guys wait and see if something more happends, or push for CXL or CXL + PRK? The cornea thickness is scary, however we measured manually and it is above 500 microns according to the eye doctor. I currently have 20/20 or close to with ghosting glares and stuff using 0,25 -0,75 cylinder spectales, so i must say it is decent.

However i presented some material about PRK+CXL for my eye doctor, but she said dont hurry into such things, it is too new. (I was their first CXL patient )

The thing is that theese ghosting and night problems disturbs me, but i dont know if i dare to try to operate, how safe is CXL+PRK, nobody can tell ? :)

I think about trying new lenses but, too much different lenses might upset the cornea, nobody can really tell that for sure either.

So right now i am spending to much time on my vision.

Thankful for any help.

/Henrik



-- Edited by zenke on Thursday 8th of October 2009 06:19:19 PM

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Senior Member

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Date: Fri Oct 9 5:11 AM, 2009
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Hi Zenke,

Yoiu pose a good question. The trouble is the more advance your KC is the harder it can be to correct eith with contacts or surgery. That means its better to halt it as that stage where its not advanced.

However the night time glare if that will go away depends a lot on where the irregularity is, as CXL may bring it down or even with some more help with a little bit of PRK. The results are better for milder cases to get flatterning, however do you want your good eye touched ? is the question ? and what I am feeling is that you rather not.

However there is no harm in getting a consultrant with a Dr who has the most experience with what ever method you would like to opt for.

Dr K in Geece ios an obvious choice, but there are others also who has success who you may want to see for a consultant also. Do your research, do plenty.

You may want to see if a contact lens fitter can try custom soft lenses, or even a RGP fitter who is willing to spend the time to work with you. You may also want to have a plan of ation if you try a method and it does not take the fustratiing vision away.

Its understandable to us how you feel, as its not nice being reminded of the trouble, which is everytime you see, but no one else can ! and can not tell your having troubles as you look fine otherwise.

Keep sharing your thoughts with us, you wil find a solution you are happy with, but get a 2nd or 3rd or even a 4th opinion if you can.

Very best to you

Kane

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Date: Fri Oct 11 5:17 PM, 2013
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Dont get fooled , PRK in keratoconus IS NOT refractive surgery. It should be stated and bolded. It is however therapeutic surgery what means they usually try to give a cornea overall better shape reducing cylinder but at cost of increased myopia(so you can use lenses more easily). There is just not enough tissue to do full PRK. Therefore if you have vision close to 20/20 with higher order aberrations (like ghosting halos etc) its probably not gonna help you anyway and can cause more problems.
Ghosting, halos etc are usuall side offects of prk.

also statement about PRK in KC not being refractive surgery is Dr K own words

www.docstoc.com/docs/97204898/The-Future-of-Corneal-Collagen-Crosslinking---Wellington-Eye



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Date: Fri Oct 11 11:46 PM, 2013
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I don't believe Orbscan is sufficient to detect minor changes in corneal shape. Definitely not as good as a pentacam can. I would obtain Pentacams now and 6 months later and see if there is any change. Best option would be to see Dr K and get his opinion. Topography guided PRK with simultaneous CXL does improve higher order aberrations. My right eye was close to 20/25 with myopic correction. After PRK and CXL, the amount of myopic correction diminished and the higher order aberrations are almost resolved. In my opinion your best bet would be seek consultation with any of the ophthalmologists doing the Athens protocol or some variant of it.



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