Phakic/P-IOL

[Michael O'Toole]

Hello,

I'd appreciate some advice, please.

I've had KC since the age of about 13, I'm now 36. Since my diagnosis, I've worn hard contact lenses in both eyes. I had a graft 16 years ago and everything is cool on that front, although there are remnants of two sutures buried deep in the cornea, which they keep trying to dig out, without success. But I don't think they're too worried.
Today I went to the clinic and the professor examined both my eyes. The professor said he was worried about the possibility of infections in both eyes. He said it was something of a miracle that I've never had infections as I have had hard lenses for such a long time. He also said I couldn't wear the lenses forever as they have the potential to cause so much damage.
Anyway, in the heel of the hunt, he said he was going to examine the possibility of Phakic implants.
I'd never heard of them before, but he explained they would be implanted into my eye, obviating the need for lenses and meaning I could wear glasses, thus meaning no infections.
I've done some initial web research on them - they seem to be new(ish), quite effective, but also quite risky.

I'm just wondering has anyone here had Phakic implants. If so, was the result positive?

Also, I know KC can't make you blind, but can infections caused by wearing hard lenses?
Finally, he was also raising the possibility of a Phakic implant in the eye in which I had the corneal graft, but he said that could be "tricky" - I take that is a medical euphemism?


Thanks.

[GarethB]

Hi and welcome to the forum.

Can not help on the implant front, but personally I feel as lens wearers were are no more seseptable to infections than anyone else as long as you follow good hygeine.

12 months post graft I was working down sewers and I have had both eyes grafted. I have worked with all manner of things that could lead to infection and so far by following simple hygeine I have never had an infection.

My grafts are 18 years old and as healthy as they ever were. It is what the graft is attached to that is the problem

I have been told to quit smoking more times and I have never smoked

As with most things in life, if we use our lenses responsibly, keep them clean and do not over wear them, there is no reason why they should cause problems. Especially if they are fitted correctly.

[Lynn White]

A phakic implant is a lens that is implanted inside the eye without removing your own natural lens.

"Normal" implants that you hear about are when people have cataracts removed. In these cases, the person's own lens is removed and replaced with a plastic one.

Phakic implants are used to reduce high levels of short or long sightedness by placing another lens inside your eye either between your own lens and your iris or in front of the iris.

The only problem I can see with this is that this still will not reduced the distortions created by your KC cornea. This is the major reason why contact lenses are prescribed in the first place. Unless the main reason you are wearing contacts is a high prescription rather than becasue of distortion (which may well be the case in your grafted eye). Before you go ahead with this surgery it would be best to let them show you what your vision is like with a full spectacle prescription and to discuss exactly what sort of results they think you may have.

I have seen the reults of quite a few phakic implants (generally excellent) but not with KC!

Infections can be caused by any contact lens wear and if they are bad enough to cause ulceration, can produce scarring. However, it is not as if you have had a history of infections yet!

As ever, to get the fullest possible information you need to discuss your own particular case with teh professionals who know your eyes best!

Lynn

[Andrew MacLean]

It is absolutely not true that KC cannot make you blind. It can lead to the loss of sight to the extent that you are legally blind in most jurisdicutions, including the UK. When I became contact lens intollerant, I was registered blind.

Many KC suffrerers are legally blind when they take out their lenses.

Lynne always gives sound advice. I'd go back and ask all your questions of the opthalmologits that the optiometrists who are responsible for your contact lens wear.

Andrew

[Sajeev]

Michael,

Send me a PM and i'll get you in touch with just the right person who has personal experiance with Lens Implants and Keratoconus (so much so that he brought himself a sports car, as his vision is so dam good now!!)

All the best

[Michael O'Toole]

Thanks, everyone.
Andrew, can I ask what happens if you do become contact lens intolerant?
Are there any alternatives, apart from an implant, or is that it?

[GarethB]

Christmas 2005 the optoms thought I had become contact lens intolerant, but by cutting out drinks with dieretics from caffeine or artificial colourings and so on with water and using lubricating eye drops the whole effect was reversed over a three month period.

12 months in, I still use the ey drops and drink atleast 2 litres watre per day and 2 hours very uncomfortable lens wear is an easy 12 hours and I can go 16 if needs be.

[Michael O'Toole]

So, is it possible to wear hard contact lenses every day for 40-50 years, as I hope to?

[GarethB]

Not sure about that, but from a survey the group did many years ago it was thought that the members were the more extreme cases.

It is thought that a vast majority of people cope perfectly well for the rest of their lives with contact lenses or glasses which is why only about 10% of us will need a graft in one eye, even fewer a graft in both. So from that statistic it is often assumed the rest must be coping perfectly well.

This is taken purely form the discussion I have had with the specialists in KC I have met at local group meetings and confrence.

I think the imprortant thing is to be sensible in what you do regarding sight management.

[Andrew MacLean]

I was part of a study being done in G;asgow to see if long term contact lens use couyld be an alternative to surgical ingtervention.

In my case the need for surgery was postponed by over 20 years. The study is ongoing.

Andrew