Hybrid contact lenses

[Dek]

Hi
I have been fitted with a hybrid contact lens (hard centre surrounded by soft outer skirt) following an INTAC op as a result of KC.Although it is quite comfortable to wear when I take it out at night I experience a burning sensation in that eye. There is also some inflammation on the border of the iris and conjunctiva. I have to wait for this to subside before wearing it again.
I was told to use Amo complete lens fluid but have found that a RGP lens fluid which has more 'slip' is more comfortable but doesn't eliminate the problem. Any suggestions anyone and is there a reason I cannot use a Kerasoft lens?
Thanks for any advice.
Dek

[Andrew MacLean]

Dek

I'd go back to the clinic; it may be that you have an allergic reaction to your fluids, or a slight infection, or even that your eye is not getting enough oxygen when wearing your lenses.

Let an eye care professional see your eye and ask for advice.

Yours aye

Andrew

[Dek]

Thanks Andrew
I have a follow up appointment next month. I will persevere until then.
Regards
Dek

[Lynn White]

Dek,

You should not be using RGP solutions as the soft skirt will absorb them. RGP solutions have a higher level of preservatives in them than those for soft lenses - and thats because RGP lenses do not absorb the solution they are soaked in. Soft lenses do. To eliminate the possibility of you being allergic to the solutions, you can use a hydrogen peroxide system AoSept, Sauflon multi etc...

If that makes no difference, then it is possible, as Andrew says, that you are not getting enough oxygen to the eye. You could always ring up your fitter/clinic etc and ask advice.

As for KeraSoft, this is impossible to say without more information! Have you had a trial with this lens? Hybrids are often used to try and get good vision when there is high astigmatism, as it has a central RGP section. However, KeraSoft can successfully fit high levels of astigmatism - I recently fitted someone with 17.00 D astigmatism and he got 6/7.5.

Lynn

[Dek]

Thanks Lynn for your advice. I will try and persevere with the soft lens solution. A hydrogen peroxide solution sounds more like a sterilising agent-is that the case?
I do have a high level of astigmatism in my right eye. Is there a limit for this and also for steepness of the cornea when a kerasoft lens is unsuitable? Is it an exact science in this respect or a case of 'suck it and see' what suits the patient best?
Many thanks for your professional advice, it's much appreciated.
Regards
Dek

[Andrew MacLean]

It is really a bit of both: There is an exact science involved and there are variations in what each person with KC will need.

When Lynn advises against using RGP lens solutions with soft or hybrid lenses, that is based on exact science; she set out her reasons in her post above. The Hydrogen Peroxide systems involve the use of Hydrogen Peroxide (H2O2) and a neutrolizer that reduces the medium in which the lens is held to Water (H2O).

Enter H2O2 Contact Lens in your search engine and you will get a load of sites that you can visit to read about this sort of system.

All the best

Andrew

[Dek]

Thanks Andrew for your reply.
My question concerning the exact science bit really related to the degree of astigmatism/steepness of cornea. What I really wanted to know is are there upper limits for each of these above which something like a kerasoft lens would be unsuitable which would then require some form of RGP? In essence how does the Optometrist decide which lens to try first?
Regards
Dek

[private104]

Hello.

My optometrist tried RGP lenses first and as my corneas have become too steep she has started trying hybrid and soft ones. I've read in here about sclerals and mini sclerals. I quite fancy giving them a shot. I think Lynn works for the people who make kerasoft lenses. I'd be interested to know about the conditions that make them right.

[rosemary johnson]

In general, scleral lenses can be used on eyes that are too steep for corneal lenses (the ones that are rougly iris-sized).
I don't know why they put me straight into sclerals age 14 - whether my eyes were already too steep for corneals, or what.
There is no doubt science in the form of rules of thumb about, in general, corneal lenses will cope with up to X steepness, and beyond Y steepness, only sclerals will have a hope.
But we're talking about human beings here, and some of us will break every rule inthe book. SO there are doubtless people who ought not to be able to cope with corneal lenses but do, and those for whom scleral works better than everything else though they ought to cope with something else bu don't, and lots of other things.
My experience is that an experienced practitioner will look at an eye, and any current contact lens, and have a good idea what to try in it. and mostly they will be right, and sometimes the person will surprise them.
Of course, all KC eyes are unique and some are much harder to fit with anything than others.
Rosemary

[Andrew MacLean]

Yes!

I tried soft lenses but they would always 'tighten' on my eye after about quarter of an hour and need to be yanked out. Bit of a wash-out for me. The problem was that I did not really try them until my eyes had stopped accepting anything else a change that came suddenly and unexpectedly.

I am back to trying RGP corneals again, but didn't even try to get it in today. Yesterday was just horrible with the lens in; felt at times like giving up before I'd completed the 2 hours I was supposed to have it in.

Tomorrow is another day.

Andrew