Hi. I'll be happy to help you with your question
Are you online?
You stated that you have worn contact lens for a long time. Is the reason you are considering a corneal transplant because you have a large amount of apical scars and CTLs aren't working for you anymore?
Hi yes i am
No the main reason is that my right contact lens no longer fits, i need a sceral lens which is cumbersome
I emailed Dr Wachler in the States and he said i was a good candidate for cross linking procdeure but here in the UK doctors have brushed that aside saying i need a graft which i wanto avoid at all costs. I have pentcams but not sure how to send them to you
I can understand that about the scleral lens. I do not know Dr. Wachler. A quick check of the American Academy of Ophthalmology does not show that he is a member. Not all US ophthalmologists are members, but most are.
He is a famous refractive surgeon in Los Angeles i believe
This site had not yet been set up to send large files or pictures, but I think I can give you some answers that may help you in your quest to learn more about your options. I assume you are outside the USA but that travel for treatment would not be a problem for you?
No that would not be problem i can travel
By the way i do have scarring to both corneas- years of contact lens wear
He has a very famous looking web site, that is true. I'm kinda old fashioned and sometimes worry when someone blows their horn so loudly about a procedure that it not accepted/taught/used by other corneal experts.
I'm sure that you know corneal transplants are very, very sucessful in keratoconus. In that light, however, it is a big surgery with all the risks of an invasive procedure
Yes so if i have severe thinning of my cornea say 225 microns and lens are difficult to tolerate what would you suggest as an alternative to a graft?
that is a very thin cornea indeed. I really think that, if you can't tolerate the scleral lenses, that corneal transplant is your best course. I don't want to blow off Dr. Wachler though without talking to another corneal expert. A very good friend of mine is the chairman at a ophthalmology program in Texas and has over 25 years experience as a teacher and a expert in diseases of the cornea. He taught me how to do corneal transplants over 15 years ago.
if you don'
If you don't mind, I like to call him and ask him about Dr.Wachler's treatment and what he would recommend. I trust this man 100%
yes that would be good thats the reason i am making the enquiry
Ok. It may take me a few hours to get hold of him and get back to you. It's almost 5 pm here. Can you be back online in 2 hrs, or is that too late where you are at?
I am sorry but its late here and would need to go to bed
I am in the UK
Ok. I understand. I can type the information I get in a question/answer format and you can read it when you get up. That should work. And if you have any other questions we can go through them too. You will have more information soon, I promise.
Where will i able to read this information ,will you email me?
Right here by logging onto your question.
excellent with that i will say good bye for now and thank you for taking the time to chat to me
Do i now click the accept button?
Wait! I've got him on the phone....
we're talking.......he say's hi.
He knows about corneal cross linking. with and without taking off the epithelium
say hello to him from me!
yep thats right
epi on its called i think
do you know the thickness of your corneas and where you cone is at?
and do you have blood vessels growing into your cornea?
Thats why i would have liked to have sent the pentcams to you
No blood vessels
I told him you thought your corneas were in the 225 micron range.....
The right one is the left one is over 400 microns
So the left one is the most problematic right now....
I tried to send it but it seems it does not work
the right one is
Here is what he has to say.......
the left is the better of the two eyes
nope, just got a lot of gobbleygook
oops....I ment right. Sorry. Must have something to do with the fact you drive on the other side of the street that got me all confused :)
Lol yes very true
Now remember. As an academic physician and a university professor and chairman of the department he tends to be very safe and conservative......
ok i am ready ..shoot
While he believes corneal crosslinking has it's place in the treatment of things he agrees with your Brittish doctors: Corneal transplant is the tried and true way to go and offers the best hope of good vision.
And, I must admit, I agree....although my friend has forgotton more about the treatment of corneal diseases then I've ever known
Ok thank you
I know this is not the answer you were hoping for but I believe it is an honest one.
indeed being honest is the right thing to do
best of luck to you. If you would be so kind as to press accept when we are done I would appreciate it.
Thank you for offering me a reason to call my friend in Texas.
Greatly appreciated and thank you