My history is I am a long term wearer of RGP's for about 35 years initially for myopia and about 15 years ago was diagnosed with the start of KC in my right eye. RGP's corrected the condition largely and with my unaffected left eye my overall vision was quite good. About 3 years ago my Consultant suggested trying the Kerasoft lens which I did. Within 3 months my vision deteriorated quite dramatically. My therory was that the RGP was holding the condition in check which the Kerasoft did not do. By this time I had developed KC to a slight extent in my left eye but my corrected vision in that eye was still good. More recently my vision in my left dominant eye deterirorated and with the reduced corrected vision in my right eye my overall sight barely met the driving standard with RGP's and certainly would not with glasses, something I had been previously able to attain. At my annual appointment with my Consultant last July I said I was ready now for INTACS (something I was not ready for previously when suggested because I thought my vision was still quite good). I was referred to the Royal Victoria Hospital at East Grinstead and when I had my pre-op assessment I was told by the Registrar that in his view (if the Consultant agreed) I should have INTACS fitted to my right eye and the cataract removed from my left eye! That was news to me and certainly was not detected in July. I don't know if cataracts develop that quickly but KC was said to be minimal in that eye and presumably is the cause of my poor vision which could not be corrected. I am due to have the cataract removed mid-February and a toric lens fitted. Has anyone else been in a similar situation? My Consultant has been frank and said that fitting a toric lens to replace my natural lens may not eliminate all the astigmatism due to some degree of KC in that eye. It often corrects in one area and produces one in a differnt area. I am worried that if I subsequently need a corneal graft I will already have a toric lens implanted compensating for an astigmatism that has changed-a complex situation! Are toric CL's effective? Perhaps it does not pay to look too far into the future! There is a lesson here though and that is just because you have one eye condition eg KC it does not mean you cannot develop another It's called rough justice!
I had the iNTACS fitted two weeks ago and recovery is going ok. I cannot say at this stage there has been a great improvement (although the NICE report does say that outcomes and benefit times are variable. What are other peoples experiences? Because the cornea is going to be changing I cannot get a new prescription for my glasses and consequently my vision is not good
At what time scale is it advisable to get this done? I'm pretty miserable at present-it's no fun not being able to see properly as you all no doubt know. The patient info leaflet said that vision might fluctuate for upto 3 months and trial assessments are usually quoted at 6 months. The actual procedure was done using a Femtolaser which apparently gives better results than by cutting the channels for the rings with a rotating dissector. The channels can be cut slightly smaller than the rings so that they have to be 'forced in' thereby producing vector forces as well to improve the shape of the cornea. No stitches were required and it was quite painless under local anaethetic drops, just a little discomfort. If my vision is not improved to enough to use glasses I will have to go back to CL's and I'm interested to hear other views on types other than RGP's. I did try a new from the USA type called 'Hybrid lenses' consisting of a hard centre with a softer perimeter but correction was not good so these were abandoned. I'm hoping that I will be able to revert to soft lenses if there is no evidence that it will allow the KC to accelerate. My Consultant is trying to get funding for the XLC treatment but I think that is unlikely given the state of Northampton's hospital financial state.
Anyway I've rambled on long enough and will keep in touch re my progress.
All the best.
Dek
