Twisting the KC way!

[Sajeev]

There are no two cuts ect??? its another option to correct vision where you keep your own cornea? why you getting upset for??

[jayuk]

there are no two cuts?

But you said they were surgically placed?

Button One - was removed from another area of the surface? (which is clear) and placed in the center

The area where Button one was removed from was then filled with the button which would be taken from the centre (ie the offending scared central area?)

So you said its surgically done, will they not cut the button out?....unless ive misunderstood?.... but you corrected me earlier saying it was surgically performed, and not twisted / stretched over?....yet now your saying its not cut?....so how else would it be done?

Upset?..ermm lol...no...intriguied by this idea....although at this point its not making sense from what you have now said.....but I suspect thats me!

[Sajeev]

I think the others got it pretty much straight way but with you there is a complex getting in the way which is confusing you and for which i have no time for.

[jayuk]

ermmmm OK...not sure where that came from!..but yes there is a Complex here....a very big one! a complex problem in trying to understand what you are saying! Twisting, surgical, etc...yet you say it isnt cut out?.....so which is it?..Im all for new treatments and exploring..which is what Ive tried to do here!..

To the others...if you understood how this procedure works could you tell me?...as Im keen to learn more about this...as its Surgical...yet theres no cuts...... which confuses the hell outa me!!

a) It doesnt get pulled over the central area of the pupil thus thinning the entire area

b) it is surgical yet there are no cuts....

I beleive from Johns response, he also understands that its going to involve Cuts and Sutures....so I think maybe you have mass contradicted yourself....here...per usual......

is it me, or have I read this wrong?....

In fact, if ONE person knows hw its done and understood it, thatll do me fine.....as itll answer my question....

[Sajeev]

Jay read what i wrote, there are no TWO cuts to rotate the cornea!!! your changing from saying one thing to another!! boy have you got a complex???

[jayuk]

Ahhh I see!..you have to forgive me....Im not that intelligent during the sevens days of the week!

So lets get this straight

a) there is a central piece of the cornea which in this case would be diseased?...Correct? If so, than this would be the area which needs replacing? Now from your last post, you are saying that it would be ROTATED?..Correct?..NOT replaced...but ROTATED....therfore....and correct me wrong here, that would mean we would need to get a Trephine (cook cutter) to take the tissue out and rotate it upto 270 degrees?......So, without even getting into the definition of CUTS, can I assume that the whole central area would be cut out in a circular manner...using the trephine?..and then sutures up?

The above is a definitive explanation of what you are saying....are we clear on that?.....

[GarethB]

Jay,

I think you have finally got it

When I was first diagnosed with KC, the way the cone drooped the lens would slide off. I see this techneque being able to move the cone so that instead of a lens dropping off it mean the lens could hang on the cone.

Secondly as this appears to me more for scarring that is in the field of vision but the KC mild, the scar is effectively moved out of sight.

As we know from hydrops and that fact this used to be introduced deliberatly because the scarring would help strengthen the KC area and in some cases improve vision that this techneque could also help KC further and as Sajeev says make lens fitting/correction easier without going down the graft route.

[John Smith]

Just to help avoid confusion here... this is what I understand...

The central part of the cornea is cut out and the button is removed, just like in a PK graft.

Then, instead of a donor button being inserted, the original button is rotated so that no scar tissue would be over the pupil, and the button is sutured back into place.

So it really is a self-transplant!

To me, it sounds an interesting idea, but personally, I'm not keen. As the eye is receiving your own tissue, there is no rejection risk, which is good; but this tissue still has KC, and that may still progress, leaving the patient with the possibility of a conventional graft in the future.

Even though only a few of us would need the conventional graft, I personally wouldn't take the risk of needing two operations to the same eye.

Still, it does sound like an interesting technique, and one that could be useful for some people.

[Matthew_]

For what it is worth; its very easy to become confused! I struggled a bit with this one. But it reminded me of the brief my opthomologist supplied with me with, trying to describe a 3-D problem in words; I pretty quickly glazed over, then I lost it. I will do better next time, but sperical trigonometry by e-mail is never going to be straight forward!
Very difficult when you are desparate to learn, so good luck and stick with it guys! For what its worth if I tried to explain I would be a lot worse and wrong in the first place!

[jayuk]

Ok, im glad that it wasnt just me who struggled with this one...it just needed a good explanation!

Anyway....to be honest this would be an utter waste.........from a procedure perspective, as you are going through the whole PK process in essense...

What I was trying to get to...was what the full procedure was...and now Ive kinda summarsied it...its just clear that with a DALK et al do you really wana go under the table with the same cornea that will more than likely increase the KC in the years to come?? Do your really want to have to go through the recovery period of the "self transplant?...do you really want to risk having to do all this again? NO......Its like saving £20 to spend £1000 in 3 years!...........aside from burns / corneal damage (non KC related), in my opinion, this procedure would be an utter waste...and id suspect no credible Optham would even take this further.......Id even question where it was seen, if it was at all....but happy to be corrected on that!

Even if you wanted to limit Rejection, more than that of a DALK, its a waste...as if you have got to the stage where the cornea has misted up / go too cone shaped; the chances are that the KC will have progressed...

Utter waste...and for the Bin for me mate

J