AboutDr Anand Shroff, MD, FICS Expertise I am happy to answer any questions on eye care. My expertise is in Laser Eye surgery (LASIK, Epi LASIK), Multifocal Implants, Cataract, Glaucoma and procedures for Corneal abnormalities like Keratoconus - Corneal Collagen Crosslinking C3R
Experience OF LASIK, We are one of the first centres to use the wavefront guided LASIK or custom LASIK procedures and the only center in India using the most safest,accurate and fastest excimer laser in the world- 'The Wavelight Concerto, 500 Hz laser'. Doctors from various parts of the world train with me and few other experts in Germany each year on our wavefront procedures. Our centre is the first eye hospital to be awarded the highest certfication in healthcare- the Joint Commission International (JCI from USA) and is also the referral centre for our Wavelight Laser Technologies, Germany in India.
We have treated patients from 89 countries and this list keeps growing as more and more patients are getting increasingly aware of the benefits of treatment with advanced technology in laser eye surgery.
Organizations ASCRS [American Society of Cataract and Refractive Surgery]certified by USA- Joint Commission International
Publications http://www.shroffeye.org
Education/Credentials MD Ophthalmology and FICS [Fellow of the International College of Surgeons]
Awards and Honors please see http://www.shroffeye.org and www.lasikindia.in
Question QUESTION: I have been to two consultants .One for lasik operation other for keratoconus diagnosis .
My details are
left eye : -3D , 0.5 (astigmatism ) , 569 um central corneal thickness ,kisa % index 151
( Alegretto topography analyzer showing 25% chances of having keratoconus )
right eye : -2.75D , 0.5 (astigmatism ) , 565 um central corneal thickness ,kisa % index 54
( Alegretto topography analyzer showing 0% chances of having keratoconus )
Age : 30 years .
Stable vision for last 13-14 years
Left eye topography is showing some abnormality .According to first consultant topogrpahy
is showing signs of having early keratoconus .
Second consultant did orbscan and slit lamp examination ,he says that there is some
abnormality in left eye but it is not keratoconus .
It has left me confused .
I have two questions .
a) Can I undergo lasik surgery in one eye and continue to use glasses for other ?
b) Secondly is it possible that topography for left eye is showing
abnormality because of infection from contact lens wear ? I used contact lens in dusty environment.
I remember having infection ( 4-5 times in a year) in my left eye.
I did discontinue contact lens wear long time (2-3 years ) before undergoing topography.
I hope I provided enough information and thanks in advance.
ANSWER: Dear Satyam,
Thank you for the excellent information provided by you.
Yes, I do understand your concerns.
Firstly, please appreciate that both eye doctors have detected some abnormality in the cornea. One labels it, other does not, however, it still is not a normal map.
What I would recommend is not to 'jump' in for LASIK, definitely not if it is keratoconus, nor if there is a ? corneal issue. I would suggest to wait for few months and repeat the topography and compare with the earlier one for any changes.
Secondly, with keratoconus the latest line of treatment is aggressive to stop its progress (called C3R or corneal collagen crosslinking).
If there is keratoconus in one eye, there is a possibility of it developing in the 'silent' eye too, hence one eyes LASIK is also not suggested.
Corneal infections occur in the thickness of the cornea and are well differentiated from the corneal abnormalities like Keratoconus.
Please read more about both LASIK and keratoconus on www.lasikindia.in
Hope this helps,
Regards,
Dr Anand Shroff, MS (OPHTH), FICS
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: thank you for answer Dr. Shroff!!
just adding to question .
I underwent C3R procedure in june 2007 in keratconus suspect eye .
Would phakic IOLs would be suitable for my case provided keratoconus progression has stopped ?
My power is less than -3D in both eyes and I read somewhere that phakic IOLs are considered for moderate and high myopia only .
Moreover I have consulted one doctor for Intacs implant but they do not correct astigmatism and according to doctor they tend to produce side effects(halos etc.) when used to correct power more than 2.25D .
I would really appreciate if you could suggest me something that can give me good unaided vision .
thanks in advance
Answer Dear Satyam,
You are one of many desiring unaided vision. After keratoconus treatment with C3R we recommend no surgery till after 6 months or untli the corneal topography appears stable.
The possibility of putting Intacs has its own risk and hence we too like the doctor you visited do not advocate it at this point.
Phakic IOLs are for higher numbers, it does not make sense to insert a lens in your case.
After C3R the possibility of undergoing LASIK is in a research stage and hence not recommended at all at this point. Hence, am surprised if any doctors even considered this possibility for you.
I think that you need to be more patient and definitely not undergo any surgery at this point, instead focus on the fact that you have keratoconus (we do not perform C3R in suspects, but observe them if they truly are keratoconus with sophisticated tests like the topography maps from Pentacam etc.)and visit your doctor regularly to see if there are any changes in your cornea.
Until then please consider wearing contact lenses.
