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Post Info TOPIC: Keraflex - Corneal flatterning with out tissue removal


Veteran Member

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Date: Tue May 10 10:51 AM, 2011
RE: Keraflex - Corneal flatterning with out tissue removal
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Remo wrote:

Just a quick note to say, they are doing Keralex here http://wellingtoneyeclinic.com/

You may contact them to find out more.

Remo


 Hi Remo,

yes Dr. Cummings from Wellington Eye Clinic has published first results.

http://www.wellingtoneyeclinic.com/media/KeraFlex_and_Cross-Linking_for_the_Treatment_of_Keratoconus.pdf

 

but it is also avaiable now in Germany in Dr. Paulig- Augenklinik:

http://www.paulig-augenklinik.de/index.php?project=paulig&pageID=leistungen,operationen,keraflex

 

I am wondering how much it will cost and what the stability of this procedure is. For all patients with too think cornea for CXL and PRK this would be a great thing.

Everybody who should try this procedure please post here. 



Andi

 

 



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Ophthalmologist

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Date: Fri Jun 3 8:54 PM, 2011
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I was asked by one of the website founders to offer some comments.

Firstly, can I say that I do feel for you all.  Youngsters with visual problems, not really a recipe for a foundation for life.  Whilst we all as surgeons strive to achive the best we can for our patients, KC is like very few other diseases in that every case is very different in signs, symptoms and severity.

I have been underwelmed with INTACS and so saw keraflex as a good alternative.  As you maybe aware, I am the first to offer this in the UK.  It does give some amazing results.

http://news.sky.com/skynews/Home/UK-News/Microwave-Treatment-Could-Stop-Cornea-Problems-Which-Affects-30000-Brits-A-Year-Called-Keratoconus/Article/201105416002025?DCMP=News-search-sslc&lid=ARTICLE_16002025_MicrowaveTreatmentCouldStopCorneaProblemsWhichAffects30,000BritsAYearCalledKeratoconus&lpos=searchresults

I have seen enough data and the results have been far better than any other treatment available, at least in the timescales we have been using keraflex.  I would say though, CL should be the first line in all cases, and only when these fail should surgery take over.

I completely understand concerns that the data is not robust andlong term, but can we really wait 10 years before starting treating.  This doesnt make much sense, so I have looked at the science and made a judgement call. 

the most common eye operation in modern days, cataract surgery, suffered similar problems and it wasnt until some surgeons persisted and kept presenting data did the ophthalmic world take it on.

It is true that the early users will experience a learning curve that we pass on to our peers, but this is how we work in medicine.

I remain heartened with keraflex and KXL and hopefully this will prove to be the standard treatment for al keratoconics in the future.....time will tell!

smile



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IR


Senior Member

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Posts: 143
Date: Fri Jun 3 9:59 PM, 2011
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Thank you very much Dr Rahmanfor for telling us the latest, and thank you for being proactive for us.

Kane



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Date: Mon Jun 6 9:40 AM, 2011
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Dr Rahmanfor, thankyou for taking the time to post here. Please continue to keep us updated with the latest information.

Chris

 

 



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Date: Mon Jun 6 7:03 PM, 2011
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Dear Dr Rahman,

when will you publish first data? Maybe after 12 months?
I think we all are excited to know about the stability of the results.

Patients definitely otherwise need to have keratoplastic of course are your first candidates, but there are so many of us with grade 1 or 2 maybe 3 that wonder is it worth, will it work? Especially for the price I have heard?

Why you take so much money for it, I heard about 5000 Euro per eye for Keraflex and KXL? I know the device from Avedro is expensive but you definetely shouldnīt abuse your monopol at the moment.

That is my opinion , so with a cheaper price e.g. 2500-3000 in total you would get more people that try this procedure and can afford it.

I have heard in islamic countries often there are people against cornea donors due to religion. So from the rich people, like oil princes, take their money and help the poor one. Donīt get me wrong it is not personal.

By this you will get more patients, better statistics and still have your margin.

I am not sure what the others think...

But it is good that you offer this procedure. We need innovative modern surgeons, of course with a good risk/chances awareness and social responsibility.

 

Andi

 



-- Edited by metallic2010 on Monday 6th of June 2011 06:05:59 PM



-- Edited by metallic2010 on Monday 6th of June 2011 06:07:22 PM



-- Edited by metallic2010 on Monday 6th of June 2011 06:08:27 PM



-- Edited by QuintriX on Monday 6th of June 2011 07:23:02 PM



-- Edited by metallic2010 on Monday 6th of June 2011 07:26:39 PM



-- Edited by metallic2010 on Monday 6th of June 2011 08:04:22 PM

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Ophthalmologist

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Date: Mon Jun 6 9:37 PM, 2011
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Dear Andi,

Thankyou for the comments.  I am not sure when data is going to be released.  I will wait for 12 month data before presenting my own.  Data is currently in the hands of AvedroI believe, but this is data takes along time to analyise and get published.  Most of the data has been presented to ophthalmologists at international meetings.  I have to say, this technology (thermal keratoplasty) has been around for many years as conductive keratoplasty, so we are aware of the complications of this procedure for about 10 years.  The reason CK lost favour is because it was unpredictable and was aimed at normal individuals for refractive correction.  Keraflex, is more precise and with KXL is more robust.

 

In terms of cost, this is down to the clinic.  As I understand this, the overheads are huge accounting for the cost.  The price is no different to INTACS, however and was designed to be an alternative, non invasive and better in terms of visual outcomes for moderate and severe KC.

 

Happy to answer any questions on the topic if you wish.

 

 



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IR


Veteran Member

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Posts: 25
Date: Mon Jun 13 6:48 PM, 2011
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Dear Dr. Rahman,

thanks for your answer. So I hope your clinic will reconsider about the price in future.

My question is, how can this procedure exactly change cornea? I researched a bit and at the moment it seems to be that this metal annulum is only able to give the same applied microwave energy. Although the thin parts of the cornea are more effected than thicker the parts. That should be the reason why steeper areas are flattened the most. And this is ofcourse the aim.

But wouldnīt you agree that in fact up to now there is no real mechanism to steer the change of the cornea with different energy on different points of the cornea?

I think for an exact modelling for refraction and shape a different energy level within the annulum is needed , so different energies on different parts. For corneas that are maybe amsler grade 1 oder 2 maybe 3 I think this is essential to know.  Otherwise it is a kind of gambling. And in these stages you can do things worse or just stay the same if you donīt crosslinking after a bad reshaping, but of course with paying thousands of Dollar for "nothing". Sorry my hard words.

At the moment I have heard that in most cases at first there is a massiv overcorrection and because of this you have to wait with the KXL. Then you must hope that the shrinking regresses again and you have to wait for the optimum moment for crosslinking. 

Would you perform Keraflex on corneas with grade 1 or 2 however? Or What is about the contact fitting process? Have your patients experiences with using contacts after the procedure? Has the vision improved? Is a better fit possible than before?

I hope not too many questions.

Best regards

Andi



-- Edited by metallic2010 on Monday 13th of June 2011 05:59:54 PM

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Ophthalmologist

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Posts: 8
Date: Wed Jun 15 12:11 AM, 2011
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Dear Andi,

 

The system is already adjustable in output.  It is designed to treat different levels of keratoconus from mild to severe.  The energy delivered is therefore varied dependent on the patients situation.  Clearly, the system would have been ineffective if only one setting was available and therefore unworkable.

The only issue is that each patient is very different and as such over treatment is possible, but at the same time this is ofetn minimal and has little impact on final vision.

I hope this helps.

 

 



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IR
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