Hello all,

I am wondering if anyone has heard of any new CLs being developed to help with ectasia/post LASIK issues...I have tried every type of lens that I've heard of--corneal, scleral, synergeyes, zwave and have been wearing different lenses more or less successfully for about 9 years but have seemed to reach the end of that road, i.e. I am not tolerating any of these comfortably anymore.

Has anyone heard of any other types of lenses that are being developed or is there possibly a category/type of lens outside of the categories listed above that I haven't heard of?

Seems unlikely but I figured this was the place to ask...

Thanks for your help, and best wishes to everyone who struggles with post RS issues.

Christine
Los Angeles

Sorry to hear of your long-term complications. There is one thought that comes immediately to mind when reading your post and this is relative to many, many threads and posts on this site.

You are looking for "any new CLs being developed to help with ectasia/post LASIK issues..." and you "have tried every type of lens" that you've heard of.

The thought is this: the sense that there is a major uniformity, some very common denominator among post-surgical patients, that would lend itself to the creation of a device that somehow addresses the majority of patients' fitting issues. The truth is, patients have been helped to varying degrees by every type of lens you mention. Unfortunately, the majority have probably found no success in all those types. It is not that any one type of (RGP) lens is best but that every type of lens requires custom work.

I had a patient whose post-LASIK frustration was relieved with a simple soft lens and, of course, that patient told every one to go get the same lens, as though her success was the "answer" when, in fact, she had a very low pre-op prescription and very mild visual complications. Her case was unique in its simplicity.

You, unfortunately, are on the other end of the galaxy in terms of complexity. No company is looking to create a "new" device to correct your condition because so few people have post-LASIK ectasia. This fact alone suggests a level of customization unique to you. It is not a matter of having "been there, done that, what's new" that will suffice but a careful analysis of your pre-operative data, surgical data and post-op data, with an eye to discovering what lens would work based on that data. I would tend to look at the ectasia aspect as a lesser component in the actual design of the lens since, theoretically, the center of your cornea is somewhat pliable and modifiable.

Every type of lens you mention has distinct advantages and disadvantages and every practitioner experienced in post-LASIK fitting has his/her own perspective on fitting, just as I have my own perspective. I would use large, corneal lenses that depend on the peripheral, non-ablated, non-ectatic cornea for support combined with your immediate post-op ablation zone data for the optics. Trying to "fit" a lens to the ectasia, IMO, is a like putting a cast on a broken limb without setting the break. I would want to avoid encouraging further ectasia which means I would absolutely avoid any design that vaults the central cornea. Sclerals and most post-LASIK RGP approaches that I have seen vault the central cornea. This is why, particularly in your case, the pre-op, surgical and immediate post-op data is critical to designing a lens.

Thank you Dr. Hartzok. What you say is what I have gotten the sense of...unfortunately. I hope that I will be able to find something that works.

Thanks for your help.

Hi Bluegums,

Don't know who you've seen for RGPs but I may be able to help you find someone who can help. Please email me privately if you're interested.