Are any NHS hospitals in Lancashire fitting Intacs?

[Andrew MacLean]

kev

Not really, they are looking for side effects so that patients can give informed consent. The UK health establishment is still haunted by the memory of Thalidomide.

As a jurisdiction, the UK is not furthest behind in the world. The United States is further behind with its progress towards authorizing this procedure.

All the best

Andrew

[GarethB]

Kev,

I had my grafts 20 years ago and silicone hydrogel soft lenses for KC have only been around for about 2 - 3 years and the current once I am on were only launched in November 2009. The earlier type soft lenses didn't allow enough oxygen through. My KC case is extremely rare in that the condition has returned in the host cornea which has resulted in the donor cornea becoming distorted and irregular.

There are a couple of NHS clinics investigating the benefits of performing Intacs and CXL, private organisations are already doing this with apparent great success. Intacs are performed first with the aim of putting the cornea into a more regular/normal shape. Once the cornea has settled post intacs, the CXL is performed with the aim of halting the progression of KC and so 'locking' the cornea into its new shape. The success I have seen so far by talking to people who perform and who have had this perfomed on them has been very successful.

[Lizb]

My consultant actually does the CXL/Intacs the opposite way round to how gareth has described. His viewpoint is he would rather do the CXL first to halt the progression and then insert Intacs into the stable KC eye. CXL, in some cases, can change the shape of the eye/improve the vision - mine has improved by one-two lines, not much but something, so my consultant doesnt want to put intacs in if the positioning is going to need altering after CXL.

It is all down to each individual specialist, I dont think that there is a right or wrong way.

[Kev82]

Hi everyone

I've asked the hospital to refer me to Mike Broadhurst Opticians. I'll see if I can get anywhere with soft or scleral lenses. Gareth I'm interested in these lenses your using, but I can't find any info on them online. I'm excited about silicone hydrogel lenses, hopefully theses will give me the comfort I couldn't get with RGP.

Kev

[Lizb]

that is the same opticians i am under for CL fitting, Christine has done my fitting (but from memory Mike saw me initially) in the past. They do have some kerasoft lenses but not sure which ones, all the staff are great in there,

[Kev82]

The Kerasoft IC looks like its best fitted with the aid of a hotokeratoscopy/videokeratography machine. Should I try to find an optician that uses one?

[Andrew MacLean]

kev

One thing you can be sure about any lens designed for keratoconus; even if it is suitable for most people, it will not be suitable for all. In your place I'd be looking for a hospital clinic that fitted a lens. I know that there are some that will fit and dispense kerasoft lenses.

Andrew

[GarethB]

Not all my soft lens fittings have been done with the aid of topography, so perhaps not completly essential, it just helps if the optom wants assistance from the lens manufacturer if they are having trouble finding an ideal fit.

As Andrew points out:

One thing you can be sure about any lens designed for keratoconus; even if it is suitable for most people, it will not be suitable for all.

The only way you will know if it fits would be by trying them. Hopsitals generally have more access to a wider range of lenses, some of the high street optoms have more flexibility when it comes to trying a different lens as they aren't restricted by the accounts department in the hospital. In the first instance I would discuss the lnes fitting options with the optom that currently fits your lenses.

When I was at the HOAC confrence in 2009, there were many optoms complaining that they couldn't fit people with the lenses that were probably better suited to their patients because the accountants said the lenses cost too much despite the optoms arguing that if they get a better lens fit, the patients eye is usually healthier so don't need to see them quite so much so saving money long term for that patient.

My hopsital are certainly saving money with respect to my eye care as I see them every six months compared to monthly which was often the case when I wore RGP lenses.

[Lizb]

RPH outsources its contact lens fitting and dont have CL fitters for KC within the eye department at the hospital. Broadhursts do have a number of different types of lenses for KC fitting, including some of the kerasoft kits.

[Kev82]

I've called Broadhusrt's and they've fitted them before and have a photokeratoscopy machine. I know there's a chance they wont work for me, so I'll keep my fingers crossed. I'll let you know how I get on. Thanks everyone.