I was diagnosed with K 5years back. At the time I had RGP lenses custom fitted. They were very uncomfortable and I never really wore them, although for the first 3months I wore them daily.
Recently my vision deteriorated and I sought consultation once more, this time getting professional advise on who to visit.
My initial exam was a 45min session in which my eyes where examined, and scanned. Corneal topology, corneal thickness mapping, pressures, etc done. I was advised that for my left eye I should have epi off cross-linking to stabilise the cornea and then we could proceed with specialized K lenses(not hard). My right cornea was too thin and vision extremely poor, corneal transplant being the only option. DALK procedure was advised.
I was given 10page info sheets on both procedures and I scheduled the cross linking then with the corneal transplant to be scheduled after. The cost of the first consultation including the scans was only R1170.
So I had Advanced Corneal Collagen Cross-linking (epithelium off). Basically it went like this:
Anesthetic drops, remove epithelium, drop on Vitamin B2 every 2min for 20min, 5min of UV-A light.
The procedure was completely painless. I was given a prescription for pain meds and sleeping tablets. About 2hrs later the pain started and was intense. I had to keep the eye closed out of pain, but it was manageable. When I woke up the next day the pain was completely gone, just a little scratchy on the eyelid. After a week the eye was completely recovered. I had eye drops for 2weeks. Almost 1 month later now and I feel the vision is slightly better.
Advanced cross linking uses a different UV light to regular cross linking so that only 5min of light is needed instead of 30 min. Discovery medical aid pays for the procedure, Profmed which I am with unfortunately does not. It cost R6810 for the one eye.
I scheduled the corneal transplant for the right eye, but an opening became available and I had it done this week. I had a Deep Anterior Lamellar Keratoplasty. Which is basically a cornea transplant keeping the very bottom layer of the cornea. I went in at 8am and walked out at 12 with a new cornea. The pain was far less than the cross linking, just a slight scratchiness for the first two days. I have to sleep with a clear plastic patch at night for 2weeks and during the day glasses for protection. It's 4days later now and vision is already better than before and improving daily, the tearing has also stopped. I have eye drops for 2weeks and then a checkup. At 4 months stiches might be taken out strategically to encourage the shape. The rest of the stiches will come out at 12 to 18months. The medical aid, Profmed, covered everything except for the imported cornea. They covered R12k and its cost was R25k. There is a shortage of corneas available in SA, but over supply in USA. The stitching is extremely precise, and came out perfectly.
I'm very happy with the results thus far but would suggest anybody with K find a good specialist and take their advise. Mine explained that I was never a good candidate for the RGP lenses I had due to the particular shape of my corneas, the lid would always be scratchy. It was also explained that I was not a good candidate for in-tacts either. At the first consultation he spent a good 30min with me discussing the options and why certain treatments were not suitable while others were for my particular eyes.
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