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TOPIC: Airline Pilot's PRK and Crosslinking Experience


Veteran Member

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Posts: 42
Date: Mon Jul 19 5:40 PM, 2010
Airline Pilot's PRK and Crosslinking Experience
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Good day to all of you KCers and well wishes. I trust that you are all very well. I furthermore  trust that all are finding solace in the viable options that are increasingly becoming available as time and technology progesses. As you can see, I had taken a little break from my entries so as to attend to my family and work schedule a bit. Keeping up with both (work and Family), as you may well imagine, demands a bit of time and to do little more else presents a great challenge. I do fondly remember my wife telling me that KC along with this blog appears to be the Mistress of my life. However so, she's well aware and mindful of the hindrance that this disease presents and the importance to garner all the essential components of information in making headway against this antagonist of our lives.


RECOVERY- APPROX 4 months Post Op.

As you may have all come to know that during this period of recovery, the changes/improvements tend to be very minute and as a result of that, your awareness of these changes tend to be overlooked than what they once were in the early stages post op. Where as the doctors visits would be spaced around every couple of days to couple weeks. It has soon materialized into every month, 6 weeks and now to just about 6 month intervals.

In visiting my Opthalmologist (Oph), he intimated that GENERAL conditions and progression of the corneas where consieralby good. The LEFT and RIGHT eye still both had Haze present but it was apparently less than what it was before.  The RIGHT eye however appeared to be dry. His discription, as he put it, appeared as if I had taken a brillo pad to my eyes as it appeared that there was multiple abrassions to the surface of the conrea. As a reult of this, the visual acuity in that eye has been impaired.

I must admit that over the past few weeks, I had taken a step back from the continuous instillation of lubricating drops. Not to say that I was no longer instilling the drops, but rather I was not doing it every second as I used to. In addition, with Jamaica's warm climate and with the increases in the use of Air Conditions and ceiing fans just to remain somewhat cool, these, as we know, tends to dry out your eyes even more. There are times that I would have to get up in the middle of the night just to instill lubricating drops into my eye so as to cease the burning. But then again, I have somewhat blamed myself because I had stopped using the Celluvisc Nightime Gel just out of share annoyance of having the gel smear against my sunglasses the whole of the next day... Sometimes its almost impossible to get the gel out of your eye lashes... lol..It's almost funny as to how much I can lose sight on what IS and what IS NOT important. Non the less, on my last visit with my Oph, he had mentioned to me that my eyes didnt appear to present any dryness as it once did. So I just assumed that  the trend would remain unchanged. Well as you can see, I was/am WRONG.
In addition to increasing the use of lubricating solutions, he also instructed me to desist in the use of the Steroidal Drop(Pred Forte) as well as the Anti Pressure Drops (Alphagan P). With the increase of one and the removal of the other, he felt quite confident that the dryness of the eye has move of a chance of being curtailed.
Overall, he was quite impressed with the progress made thus far and still feels very confident that there is more improvement in store. At the end of the session, he added that a Scleral lens might be the best option for the right eye. It would not only have the potential to drastically improve my vision through a refractive correction but also, it would increase the eyes ability to retain moisture.

After leaving my Oph, I went to visit my Optometrist to see what could be done in terms of correction. With my left eye, my vision is impeccable. Well, I wouldn't necessarily say that it is impeccable but it is a far cry from the starting point just a few months prior. My vision is just around the 20/20 - 20/25 Border and was easily correctable to 20/20 with a spectacle apparatus. The RIGHT eye however appeared to be the most difficult, if not, Impossible to correct. Apparently this was a result of the the presence of the haze and the abrasions in the optical zone of the cornea. He went on to recommend a Scleral Lens for my right eye. To hear this was a bit disheartening seeing that I was hoping to be outside the realm of hard contacts for life.... But then again, with KC, I have to remind myself that this is NOT a regular eye and that correcting the aberrations of the eye can be an impossible feat.
In trying on one of the samples of the Scleral lens, I must admit that it literally at first feels as if you have a cereal bowl in your eye. I would say that it wasnt  necessarily uncomfortable but it had an all encompassing feeling allowed it to feel strange at best. I suppose that as with RGPs and amongst other contact lenses, time typically issues comfort. In addition to the awkwardness of how it felt, it did usher in a vast improvement in vision. I was also reminded that the Scleral lens would significant reduce the dryness of eye by way of the cornea being constantly immersed in the lubricating solutions. The Scleral lens are filled with these lubricating solutions just prior to insertion.
Another hindrance to getting Scleral lenses is the expense of it. For a contact lens to be so expense baffles the mind. Fortunately, I'm told that I dont have to worry about the contact lens falling out or being dislodged. In addition, having debris that would normally wedge itself between an RGP and your cornea is almost non existent. As daunting as it appeared, I'm reminded that these effort are with purpose. I'm not sure as to how possible this may be but, maybe in the future and with the condition of my eye improved, I can have enough of a BSCVA or UCVA to operate without the lens. It has been more than liberating experience no to have to clean, store, fill and insert contacts but I suppose that this is a part of being a KCer.
Anyhow, My next appointment with my Oph is in six months and my Opt will be just about once a week. Apparently, Scleral lens as with RGPs are very tedious when it comes to fitting...
Depicted below for your perusal are my latest Topos

-- Edited by DEFPOTEC on Monday 19th of July 2010 04:42:31 PM

-- Edited by DEFPOTEC on Tuesday 20th of July 2010 03:23:32 AM

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Senior Member

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Date: Tue Jul 20 7:30 PM, 2010
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Thanks for the update and keep us posted !

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zk


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Posts: 53
Date: Wed Jul 21 7:31 AM, 2010
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thanks for the update, this is on eo fthe topics Im following since I had done cross linking a year ago.

concerning corneal haze, any possible future remedies for it that the doctor might recommend?

and despite needing to have contacts to achieve 20/20, you do however have functional vision without glasses right?





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Date: Wed Jul 21 4:31 PM, 2010
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Hi Zk,

Please forgive me for leaving that out. Functionality with both and either eye (s) are present. For that simple and extraordinary result, I would never regret having done both procedures. As with all procedures, there are inherent risks available. I'm confident that there are vastly more successful patient outcomes than there are poor ones. Thanks for following this Zk. I'm sure that with continued research and WILL, you may find a viable option and a more improved and sustainable vision.

Regarding the Haze, apparently it is evident, as you may know, with all patients that undergo corneal surgery. I assume that with CXL the haze or the development of the Haze within the cornea is a lot less than that of patients that undergo more invasive procedures such as PRK. I say that because the duration of the steroidal regimen tends to be a lot longer with PRK vs CXL. With PRK, the regimen typically extends to just around 4 months vs CXL which I think is two weeks.

As I had mentioned in my previous post, just around 7 weeks ago, My Oph had reduced my dosage from Durezol the Pred Forte which apparently is a third in strength.  At that time the haze apparently was still evident however it appeared to be less than it once was. On my last visit last week, the evidence of the haze was even more removed than 7 weeks ago so I suppose that this will be the trend.  Well let me not say SUPPOSE but rather,  HOPEFUL that this positive trend will contine.
Just last week, I was instructed to stop using the PRED and ALPHA P as a result of possible contribution to my corneas' dryness.  Now, I'm can only assume that the haze that I have remaining is of very little concern to my OPH seeing that he taking me off of the PRED.  Mind you, my next appointment is set to 6 months from now.  So again, this leads me to believe that the haze is of little concern.
I've read that haze can last in upwards of 6-12 months. As you know, all is different.

Zk are you considering PRK?

-- Edited by DEFPOTEC on Wednesday 21st of July 2010 04:01:07 PM

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zk


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Date: Wed Jul 21 7:28 PM, 2010
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Hello DEFPOTEC

I agree with you that just having functional vision without any aid, and having 20/20 with soft lenses is a great result.

In August 8, it would be my 1st year post cxl for the right eye. And on September 24 it will be the 1 year mark for my left eye as well.

my best corrected vision with glasses now is 20/25 in right eye but 20/40 in left eye. Of course due to the haze and kc this is not perfect 20/25 nor perfect 20/40.

As for dryness I sometimes go without putting any drops but usually at work, due to the ventilation and computer use, I put in on average 2-4 drops during the day.

As for haze, my optometrist said a month ago that it seems to be under control and my opthalmologist said it is getting better 2 months ago, but again at this stage there has been a delay and I hope it will resolve with time. I am being very patient here.

I am actually strongly considering prk,having a result as yours to me is very satisfactory, but I will consult with a few doctors first. Since I live in Ottawa, I will also go to toronto to the bochner Eye Institute for a consultation in the near future, and I am considering options outside of Canada as well if the need is there.

My corneal thickness after CXL is around 500 microns. The thickest part is 5 hundred and XX and the thinnest part is 4 hundred and xx (cant remember the values)

I have tried rgps but dropped them after 2 weeks, they are just not for me. I'd give up 20/20 vision with rgps, that is how much I hate them. But as you mentioned in your very earlier posts, knowledge and awareness for us is the most important thing and I had to just try them out so I know what they can give me, how they feel, etc... I like to discover all the options first and then choose the best one that fits my needs and lifestyle.

I also tried the synergeyes hybrid ones, and the optician was able to get me a very good fit but still due to the haze, vision is not perfect. But it is very functional and crispier than glasses.

and my next step, is next week I am going to get toric lenses to try them out.

I have been all over the place. lol

The most comfortable lenses I found and which do not cause eye irritation are the O2 optix torics which can be worn for 6 consecutive days and nights. I actually wear them daily and never sleep in them but because they are very oxygen permeable they are very comfortable and never cause eye irritation or redness. With these I can probably get 20/30 in both eyes. Once the haze goes away maybe it'll be better.

So for now I have not stopped at one remedy bec I am still in the healing process (waiting for the haze to go away)

For the past year or so, I have been going on without 20/20, it has been mostly in the 20/50 area and recently in the 20/30 so I am definitely considering PRK. If I can get functional stable vision without any glasses or lenses that is great and 20/20 with glasses or lenses.

My only big fear is getting dry eyes.

I do not regret the cxl however because had I not done it, my kc would have probably gotten worse.

The 2 things on my mind now, are haze, prk, and Im also looking into the new keraflex procedure by Avedro.

I can say however that 60% of the knowledge I have now would have not been possible without reading your posts and those of others and I hope I do share my experiences as well whether I do prk or other surgeries.

Keep us updated!! smile.gif

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Date: Sat Jul 24 11:18 PM, 2010
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Zk, how are you ? I must admit that it was refreshing hearing your story. It just reminds me that that I have so much to learn through the research and advice of others. Thanks for not only taking the time to share your stories but also for encouragement in te continuity of this endeavor.

I have my fitting of my scleral lens for the right eye next week so hopefully everything will go with that. As I might hve mentioned earlier, the fitting of scleral lens tends to be just as tedious -if not more- as the fittings of RGPs.
I'll however keep you up to date and I look forward for you to do the same.


Thanks again for your input.

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Date: Sun Aug 29 2:36 AM, 2010
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Defpotec, i jus read your study very encouraging. since I will be goin to see Dr. trattler this wed for the xlinking then to canada to see DR. Lin. thank you for helping make this decision.

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Togethier WE WILL FIND A CURE


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Date: Wed Sep 15 3:42 PM, 2010
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Hey Mark,

My pleasure. If there s any questions that you need answering, maybe I can help.. Do hesitate in asking. No need for goodlucks because I m sure that everything went well...

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