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Post Info TOPIC: Epi on CXL positive experiences anybody?


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Date: Mon Mar 17 7:51 AM, 2014
Epi on CXL positive experiences anybody?
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I had Epi on 7 months ago in my right eye. Day vision outdoors is better than before but I think night vision / indoor vision / ghosting is noticeably worse than before. I felt that about 3 months after the surgery my vision was almost similar to before the surgery but has deteriorated little after that. I am not sure if it's part of vision fluctuating before stabilizing or of its still progressing.

 

The steepest part of the cornea is about 0.5D steeper than before the surgery. Also I haven't yet resumed wearing contacts after the surgery. I brought increased ghosting to the notice of my doctor but he says the cornea is stable and that ghosting will always be there without contacts (which I already knew, but really did not address increased ghosting part).

 

Now my left eye which is the better eye is starting to get worse and I plan to get cross linking but not sure whether I should opt for epi-on or epi-off. My doctor suggests epi-on but I'm skeptical given my experience with right eye. I am not sure if it really worked at this time. I might know better after 6 more months but I don't have the luxury of time.

 

Since epi-on is relatively new and the results are not as convincing as epi off. Wanted to see if anybody here had really good results with epi-on. I've read a couple of posts by other members and looks like their experiences were kind of mixed as well. 

 

I also feel that results reporting flattening with epi-on may not be very reliable since most people wear contacts and that temporarily flattens the cornea giving false indications. (I've read some where that contacts shouldn't be worn for a month for accurate topography results)

 

It would be really encouraging if somebody reported long term (2yrs?) Positive outcomes for epi-on



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KVY


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Date: Mon Mar 17 7:53 PM, 2014
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You have researched a lot in all you say Kishnavy on epi on...I just wanted to add that as the pupil gets larger at night to let in more light...unfortunately the pupil getting larger allows more of the irregularity, on and in, the cornea to get picked up as light passes through the enlarged pupil. This makes night vision more problematic.

In your case may be there was a change for the better in the day a bit, and at the night time as your pupil widens you are picking up more of your corneas regularity. This suggests that centrally your cornea has got probably a little bit more regular but towards the edges away from the center, it may have not changed enough or got a bit worse.

This sometimes occurs as a trade off (better day time vision at the expense of night vision) This does commonly occur with glasses, contact lenses and surgery. So don't be too alarmed at this stage.

The thing is that they do not do eye tests in the night...but they should!

How do you do with glasses/contact lenses ? to get to your better possible vision.

Have you thought/asked about laser treatment at all? ...and again to get to your best possible vision ?

Please do bear in mind that its at around the 6 month mark your cornea should settled down mostly by, but fully this settling down can take up to 12 months.

Best of Luck, Megan



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Date: Mon Mar 17 10:29 PM, 2014
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Thanks for the response Megan. I just got the difference map from the doctor, the steepest part of the cornea increased by only 0.1D, so the results are probably better than I expected (0.5D increase was at the center which is NOT the steepest). So may be certain parts of the cornea are more regular than before and some are not.

 

As you mentioned increased ghosting at night is probably due to wider pupils picking up parts of the cornea which got slightly worse. I haven't used contacts after the surgery as I am able to manage with glasses. I will wait a little longer get CXL done on left eye as well and then get contacts after both eyes stabilize.

 

BTW Does wearing contacts help with Cornea stabilization? (I never read about that anywhere). I was able to get 20/20 with Synergeyes ClearKone before surgery. I used them on and off for 3 months before the surgery but never got used to them.

 

I haven't talked about laser correction. I am somehow skeptical about it (removing tissue from already thinning cornea) and don't want to take any chances.

I still see some variation in vision through the day usually best after resting for a while. However, the overall range remains more or less same from day to day. I wonder if others have similar variations.

Did you get CXL done as well? If yes Epi-on or off?



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KVY


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Date: Tue Apr 29 4:12 PM, 2014
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Up until this week I had never heard of anyone who'd had good results from an epi-on procedure (unfortunately that includes myself). However, then I saw this blog. Although the procedure didn't originally seem to be a success, one year on Claire Harringdon reports that her keratoconus has stabilised. So we might have come across an epi-on success story at last!

 

I have had both epi-on and epi-off and I'd recommend epi-off. My experience sounds quite similar to yours. At first after my epi-on operation my vision was terrible, it gradually improved as I recovered from the procedure, but continued to deteriorate in the long term as the op had not successfully halted my keratoconus. I spent a long time wondering whether it was the KC or the operation that was causing my poorer eyesight. Eventually I got the eye re-operated on but with an epi-off procedure. 

 

Unfortunately wearing contacts doesn't help with cornea stabilisation. They only change the shape of your eye temporarily so you won't be able to halt your keratoconus by wearing contacts.

 

Megan, I never realised what caused bad night vision before, how interesting. I've often thought that viewing a letter chart in a well lit room doesn't reflect my day-to-day problems very well and now I know why!



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Currently putting together a pool of CrossLinking experiences, to which all are welcome to add.



Veteran Member

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Date: Tue Apr 29 10:03 PM, 2014
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Hi Clare,

I myself first learnt about it, when it was described by another patient...its amazing the ripple effect of information transfer!smile

Megan



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Claire H

Date: Sun Apr 5 6:39 PM, 2015
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everyone, it was my blog that was mentioned above. I had partial epi removal not epi on cxl. So I had the surface of the cornea "roughed up" with a grater/needle style device so it was more invasive than epi on is. (Just wanted to clarify!) Also... I am 2 1/2 yrs on now and still stable in my left eye so all good!! Wishing everyone health and happiness!

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Anonymous

Date: Thu Feb 23 12:15 PM, 2017
Any updates on epi on
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I just had my epi on cross linking yesterday. Compared to what i have read about the people who had epi off, i don't feel as if i did cross linking yesterday. It did hurt on the the day of procedure but today i feel a lot better. It would be great if you guys could tell me how has been your experiences so far. Has the cornea stabalized over these many years?

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Executive

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Posts: 155
Date: Fri Feb 24 11:53 PM, 2017
RE: Epi on CXL positive experiences anybody?
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There are many ways being tried to do Crosslinking (both Epi on and Epi off) the only one proven to treat KC in the long term is the standard method developed in Europe..



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