corneal refractive therapy - CRT Lenses Anyone??

[bostondryeye]

Hi Guys!

Ive been suffering for dry eyes for about 4 yrs now and have been thorugh everything including Scleral lenses. I am surprised to not see much on here in regards to CRT lenses that are worn at night to correct vision and reshape your cornea.

Has anyone had any experiences with these or knowledge that you can share? I know how they work and my dr mentioned these to me the other day and I had never heard of it beforehand. I wanted to do some research before talking to him again further.

I have -4.0 Myopia in both eyes.

Here are the relevant sites I could find with info.

http://www.paragoncrt.com/consumers/pat_info.asp

http://www.youtube.com/watch?v=yWPUpW0c7EU

http://www.contactlensdocs.com/Corne...%20Therapy.htm

http://www.ortho-k.net/index.html

[Lucy]

I, too have the scleral lens....sitting in my cupboard. I only opened up two of your links. CRT is to mold your vision, not a treatment for dry eye. On one of the links I read, it specified that if you have dry eyes you should not try CRT.

I've been around dry eye boards for 9 years and have never heart CRT mentioned for dry eyes. Maybe the boards I visit are behind times. Maybe someone else has used this for dry eyes.

I've heard and seen doctors recommend many different things and this was not one of them. I'd be wary.
Lucy

[calli66]

I was interested in the process, but my myopia is too high. Even then, my eye doctor thought they were successful up to about -2.00 D of myopia, not -4.00 D. His office offered the Paragon CRT, but I got the impression that the successes were not as "glowing" or as numerous as the ones shown in the marketing youtube video.

According to one of your links--the last one, think-- having dry eye means you would not be a good "candidate" for corneal reshaping. The list of Contraindications:

Acute and subacute inflammations or infection of the anterior segment of the eye.
Any eye disease, injury or abnormality that affects the cornea, conjunctiva or eyelid
Severe insufficiency of tears - dry eyes.
Corneal hypoesthesia - reduced corneal sensitivity.
Any systemic disease that may affect the eye or be exacerbated by wearing contact lenses.
Allergic reactions of ocular surfaces or adnexa which may be induced or exaggerated by wearing contact lenses or use of contact lens solutions.
Any acute corneal infection - bacterial, fungal or viral.

You'd probably want to take this list seriously before spending a lot of money on CRT. But at least it's reversible. If you have dry eyes, the lenses would be quite uncomfortable at night (painful), because we don't make as many tears when sleeping as when awake. There might be some corneal damage from lack of tears.

Just my 2 cents. I was all excited about Paragon CRT when it first came out, so I understand the feeling.

Calli

[bostondryeye]

Thanks Guys! I am also seeing these side effects from research and realizing that video is pretty bogus! Im gonna talk to a few specialists to see what they say, so far Ive been getting mixed opinions and my myopia is -4.50.....

[calli66]

I think that the most important drawback would be wearing the lenses at night. Even for people with normal tear function, sleeping in any type of contact can cause problems like abrasions and infections. When you're asleep you don't make as many tears, plus, you're sleepy and not likely to get up and take the lenses out if they start to irritate.

Maybe a really really determined person (with mild dry eye and no other problems), who had lots of time to devote to the process, could wear the lenses in the daytime. I think there would be less risk that way. In the beginning, the lenses are worn in the daytime, as well as night, until the cornea is flattened. It's just for convenience's sake that the "retainer" is worn at night---after the correction is achieved----that way, you're under the impression that the vision correction is free and easy. Takes place while you're asleep, etc. etc. If it were true that the retainer lens need only be worn every 4th or 5th day, perhaps it would be possible to wear it more often in the evenings and on the weekend to get the same effect.

I'm just pondering the process, not advocating anything, you understand. Obviously, the companies use marketing and advertising to sell their product, and use a fair amount of hype. But if you go to an eye doctor, they'll give you a more realistic opinion about whether it would work for you, based on your degree of myopia and eye condition. My eye doctor did the preliminary work-up for the Paragon CRT for just a bit more cost than a contact lens eye exam. They did a digital corneal topography scan, a refraction test, and talked to me about it.

Calli

[mary kenny badami]

hi, bostondryeye --

I'm one-hundred-percent with Lucy and Calli in their suggestions of caution on this one.

I've been around the post-Lasik and dry eye bulletin boards as a patient for eight years now.
Although this process may be currently marketed or branded as as "CRT," I'm pretty sure that it's just a variation of what was originally known as "ortho-k,"
a procedure to wear contact lenses in varying shapes to reduce nearsightedness (myopia) and astigmatism -- sort of like "braces-for-your-eyes" .

Drawbacks, if I recall correctly, included:
(a) it is most effective for relatively low prescriptions, and definitely ineffective for high ones, and at least at the time it could not deal with farsightedness (hyperopia);
(b) it requires multiple doctor visits with re-fittings and re-measurements as the process continues;
(c) if you ever decide to stop the process, your vision will soon revert to its original state because this is a truly temporary and in no way permanent reshaping of your eye.

That being said, there were nearsighted patients with low or moderate prescriptions who felt that wearing contact lenses overnight was a reasonable trade-off for excellent vision by day.

Years ago ortho-k was definitely being marketed as a less-invasive alternative to Lasik for folks with mild myopia.
But I never heard ortho-k suggested as a remedy for dry eyes.
After all, it requires you to wear contact lenses for all or some of the day -- and once you reach the "maintenance" phase, most or many nights a week!

This is my non-medical, post-Lasik patient, dry-eyes-patient, few cents worth.
I'm willing to be corrected, or to learn if evidence exists to the contrary.