Hi New Member

[rob1975]

Hi,

Im a new member and have just found out i am suffering from keratoconus after going for my regular 2 yearly eye appointment. I'm 33 years old and have been wearing glasses since i was 10 and up until now i have had no significant prescription change. I will just add at this time i am a British Expat working in Dubai. Two weeks ago i went for an eye test and the right eye had significantly deteriorated and was told to book an appointment with Moorfields Eye Clinic here in Dubai. I went for this appointment last thursday and after 2 1/2 hours of tests was told i was suffering from KC in both eyes with the right being the worse and was recommended to have intacts.

This morning i have recieved the call to say the date of this is the 27th May so all in all a very quick turnaround. After a rapid bit of research on google to find out more about this condition I have found this site which has been a great help to me. I would like to know more about intacts and what to expect as i have not really been given much information from my consultant and was in a little bit of shock when told this news. Also i have read from other posts that glare is an issue with intacts and i am wondering if this could be a major problem for me as i work in a country where the sun shines 99.9% of the time? Also will any time off work be required i've been told 2 weeks off will be needed after op does this sound a sensible amount of time or can it be reduced?

As i said any help would be appreciated i've only known i've had KC for four days and i have a date for the intacts to be put in already.

Thanks,

Rob

[melissa]

Hi Rob,
Welcome... you have managed to find a wonderful source of advice and a great place to complain to people who understand...
I can't give you much advice on Intacs, but would suggest that you don't let anyone hurry you. If you are not ready, or not yet sure that you are making the right decision- delay your appointment.
There are MANY different treatments for KC and every person is different. I am sure you will get some useful advice from the site.
Melissa

[Andrew MacLean]

Rob

You agreed to have Intacs without exploring options with your surgeon? You clearly feel a bit 'bounced' into this procedure and I wonder whether you might not be happier going back to see the surgeon before you completely commit to having eye surgery.

It may very well be that you will decide to go ahead with the surgery on the date you have been offered, but did they explore other options with you; contact lenses, CXL, etc.? Have they indicated what they think would be the likely progression of your keratoconus if, for example, you did nothing? The received wisdom used to be that people whose Keratoconus was first identified in their 30's were far less likely ever to need any sort of surgery than those whose condition developed in their teens.

The problem, of course, is that the surgeon has examined your eyes and knows what they look like. Nobody here has, but nonetheless, it may be prudent for you to make a note of all sorts of questions you might want to ask, now that the news of your diagnosis has had time to sink in, and make sure that you do not leave the consultation until you have been given satisfactory answers to all your questions.

As to Intacs as a procedure, it has been passed by NICE as a treatment whose benefits where it is clinically indicated are such that it should be available on the NHS in England.

All the best.

Andrew

[rob1975]

After reading the comments posted from my original post I have asked the surgeon for my medical report and the summary section stated the following:

In summary, this patient is affected by bilateral keratoconus and would require Intacs rings implants in order to try to stop the progression of the disease and to prevent the need of a corneal transplant in the future. The Intacs channels would be created with state of the art Intralase femtosecond technology. I have explained that the Intacs operation may not improve the vision but it is done only to stabilize the cornea. Visual correction can be performed later by means of glasses, contact lenses or further corneal or intraocular surgery once the corneas are stable. There is a risk of development of halos and of the segments needing to be exchanged or removed, but benefits significantly outweigh the risks involved.

Can anyone tell me if this sounds like a good way forward or should i still look at other options??

[Andrew MacLean]

In summary, this patient is affected by bilateral keratoconus and would require Intacs rings implants in order to try to stop the progression of the disease and to prevent the need of a corneal transplant in the future. The Intacs channels would be created with state of the art Intralase femtosecond technology. I have explained that the Intacs operation may not improve the vision but it is done only to stabilize the cornea. Visual correction can be performed later by means of glasses, contact lenses or further corneal or intraocular surgery once the corneas are stable. There is a risk of development of halos and of the segments needing to be exchanged or removed, but benefits significantly outweigh the risks involved.

rob

Only you can make the judgement but there are some questions that I'd want to ask the surgeon:

I found a site that certainly advertises Intacs as a treatment option. They say

Intacs corneal implants are an exciting option for individuals experiencing an intolerance to contact lens and are facing a corneal transplant. Intacs corneal implants may be the best possible option to stabilize the cornea, improve vision and potentially defer the need for a corneal transplant.

Intacs corneal implants are indicated for use in the correction of nearsightedness and astigmatism associated with keratoconus where contact lenses and glasses are no longer suitable.

http://www.intacsforkeratoconus.com/
Note: they do not talk about Intacs removing the need for corneal transplant, but potentially deferring the need for more drastic surgery.

Your surgeon writes of this as a way of preventing the need for transplant; it would be worth asking about this inconsistency.

In the end, the decision is yours. My twopence worth would be that I'd probably have opted for Intacs at an early stage.

All the best

Andrew

[Anne Klepacz]

Hi Rob
You'll find more information about Intacs on the home page of this site under Treatment Options. Also under Frequently Asked Questions, you'll find a summary of a talk about Intacs given by a consultant to our West Mids group a couple of years ago. And if you search the discussion forum for Intacs, you'll find several accounts from members of their own Intacs experience.
In the UK, Intacs tend to be fitted for those people who cannot tolerate contact lenses, rather than being the first option. Of course, as it's dry and hot in Dubai, contact lens wear may be more problematic than in our much wetter conditions! But it may be worth asking about lens options before you make your decision.
Good luck
Anne

[rob1975]

Since my last post and a few chats with my doctor about why he has put me forward for intacs straight away I decided to go ahead with the procedure which was yesterday the 27th. Just over 24 hrs on and im pleased to say there is only a slight irritation in the right eye probably more to do with the bandage contact lens due to a small scratch that I gained during the insertion of the intacts. Been for a check up this morning and the vision is better now than before the op I know its early days so it could all change quickly but im pleased. The main problem im having now I can't wear my glasses due to the fact they seem to strong and my vision is so much clearer without them. I mentioned this at my checkup this morning and they have told me to leave them off but without having a proper vision check till the end of month 1 which I have been warned may be very inaccurate im unsure what to do about driving / going back to work. Typing this post has not affected my eyes in any way but it has only taken a few minutes rather than the hours I spend behind a VDU at work has anybody else had this type of affects and how did you get around them? Or will this temporary clear vision start to detorate as the eyes settle over time.

[Andrew MacLean]

The standard advice to people without any eye condition is that they do not spend hours on end at their VDU, but that they take breaks.

http://www.lhc.org.uk/members/pubs/books/vdu/vd06.htm

Andrew