C3 R in a good eye

[jayuk]

Louise

Checkups 6 monthly with Corneal Topographies are probably the best way of keeping KC in check (making sure you remove you lenses at least 12 hours before going each time!). Before, this was a luxury more than anything for KC patients, but now, due to the reduced cost of this machines, you can now get a Topography performed for around £35.

I guess alot depends on how regularly you get seen etc......But if I was you; id get seen every 6 months and then re-assess the situ..

HTH

J

[GarethB]

I feel a comparison can be made for the following reason;

A topography of my eye clearly shows the scar left from the graft. At about the 11 o'clock position just outside the graft is where the KC is. Normally on a topography it goes from a bluish clour where the is a small degree of steepness through the spectra to a more intense red.

As the KC is so close to the graft there is a slight troughh of the scar so I have two high points so the red looks like a bow tie. There is s tep change in thickness, the grfat is pretty uniform at approximatly 600 microns and rather than grdaulaly changing like most cases of KC, it steps down to just ove 400 micorns. Therefore Dresdon doctors concluded that it would be impossible to treat my KC with C3R without treating the good part of the graft because of the step change.

Therefore a comparison can be made as it would be like trating a KC affected eye and an unaffected eye in one as they put it. Same reason fitting me with a lens is hard as they have to get the lens to correct vision in the graft, the graft margin and the KC itself for when my pupil is dilated so that I do not see the lens edge.

The reason I did not mention the graft originally was because I thought it irrelevant so I only posted the 3 out of 5 reasons Dresden decided that C3R would be a too higher risk for me at this stage of the treatments development.

The fifth reason being that is was considerd scraping epithelial layer off could be the trigger to cause rejection as it is considerd to be minor eye trauma.

In the industry I work in, testing on live animals or invitro testing as was done on pigs eyes are both considerd to be testing on animals.

You will have to wait a few days for the Dresden contact because last weeknd I put it in the the loft to make way for vistors over Christmas, but I need to go there again this weekend so I will try and pm the info to you.

Regards

Gareth

[Sajeev]

Gareth, a tranplanted cornea and a non-transplant cornea are different, there is the penatrating cut part of the surgery. There is not one study (not even an animal one) done on transplanted cornea so there is no facts, there are just a whole lot of unknowns.

To do surgery or not when there is no KC is not what any KC treatment is for. If the desired effect is to stop KC then it must be there in the first place.

The IROC who i know, know its more benfical if you don't hit the advanced stages of KC when you have this treatment, as was seen in the early study results, its not due to thickness, but for other reasons.

[Louise Berridge]

OK thanks Gareth, whenever is convenient.

Thanks J for recommending 6 monthly. I was thinking it would be better to have the thickness regularly tested and not just relying on the topog. This would pick up early thinning. I'm guessing the topog won't change until the thickness becomes thin enough to mishapen.

Does anyone know if the pressure of the thickness test could trigger KC? As the eye is numbed, I'm not sure how much pressure they are applying when the readings are taken.

Gareth and Sajeev - Your mini debate has slightly confused me, so I'm not sure whether having the C3R in a good eye is advisable or not.

[jayuk]

Louise

Having Thickness test is a good idea also...but not all areas offer this....and to be honest a topography would suffice.....at least thats what I have been doing for past 4 odd years.....

With regards to the thickness test and it triggering KC, I would strongly suspect that No is the answer to that..as the pressure thats applied is minimal and its really a "touch" test with ax extremely sensitive node on the end of the measuring device.

Louise, I can see why you may be confused from whats been posted....and its kinda gone off on a non-related tangent

Let me kinda summarise

When a KC affected eye has a graft (AKA corneal graft or transplant!!) the affected keratoconic tissue is removed.

Now the surgeon aims to remove all the KC affected tissue but this is not always possible. In some instances doormant KC tissue, or even KC tissue is left behind. Gareth was pointing out that it was this tissue that he wanted to halt...and thus KC tissue that was already present in the eye.

The professionals in this area told Gareth that performing C3R on this area would more than likely spill over to the "normal" KC tissue and thus the thickness across the wider area of the cornea would thicken. What this would mean is that his own tissue and the grafted tisse would have varied thickness

Hope that makes sense.....

With regards to your "good eye", if it doesnt have KC, do not have this treatment performed. Once you have been clinically diagnosed, and hopefully this will be a very mild stage if you use the 6 monthly protocol; then you can reevaluate and possible get C3R

HTH

Jay

[Louise Berridge]

Hello Jay,

Thanks for explaining.
Have your eyes stabilised?

I think I will try to arrange a regular thickness test, as I would have thought that this should pick up any changes quicker. Do you go to the London Vision Clinic?

Cheers
Louise

[jayuk]

Hiya Louise

No, my C3R still fluctuats and its some 15 months now...but the fluctuations are that high....but bear in mind I dont use that eye much.

I get seen at Centre for Sight.

J

[Louise Berridge]

Your C3R eye fluctuates? Has it got worse at any point? I was led to believe everyone had stabailised at worst.
Have you had any thickness tests on that eye?

[jayuk]

Louise

I didnt have the epithelium removed, at MY request. As the treatment was too new and Id rather be extra diliigent then rely on 5 years worth of data at that stage.

Its remained stable through the couse, but does change here and there. However!, this could be because I didnt have the treatment as advised, and also the KC in that eye could be progressing or causaing changes...

Not had any thickness tests to be honest...but Ill ask for one next time I see my consultant

J

[Louise Berridge]

Hi J,

Aah OK. I think you were wise not to have it removed. I would have opted for that, but I was advised to have it done and told it wouldn't cause any harm and grow back quickly. I would have thought not having it removed is still effective to some extent, and reading the posting by Chris, the US clinics only offer this, and they've had good results.

I was told topogs can vary, even if you took 1 after the other.

Louise