considering RGP or scleral lenses

[vancouver-lasik-victim]

Hi everyone, this is my first post here. I've been an observer for quite a while, and have gotten a lot of ideas out of the forums, but sadly no real success yet. I'm almost 10 years post-lasik, and it just seems to be gradually getting worse. I actually suffered for many years without a diagnosis. Eventually I self-diagnosed by reading on the internet.

I'm considering trying scleral lenses. I was initially considering going to see Dr. Greg Gemoules, but obviously from Vancouver, Canada that's a bit of an excursion. I found that there is a local doctor who (Steven Lee) who specializes in "post-surgical corneal rehabilitation."

http://www.myorthok.com/postsurgical.php

Does anybody have any experience with Dr. Lee?

I contacted him and he replied very promptly. I asked if he fitted scleral lenses, and this was response:

"We fit RGP lenses to help post Lasik complications. There are large RGP lenses available without the need for scleral lenses, if that is what you want."

Does anybody have any experience with the large RGP lenses he is referring to? What is the difference between a large RGP lens and a scleral lens? I thought a scleral lens WAS a large RGP.

If the large RGP lens is unlikely to help, I'd rather not waste any time/money on that option, since the scleral lens option is likely to be quite expensive.

Thanks in advance for any responses,
Kevin

[Rebecca Petris]

Hello Kevin and welcome.

You must have had LASIK around the same time I did. I remember emailing with Steven Lee waaaay back in the beginning of my LASIK adventure, in 2001. He was very kind and helpful to post refractive folks. I didn't end up seeing him though, partly because I was moving.

I contacted him and he replied very promptly. I asked if he fitted scleral lenses, and this was response:

"We fit RGP lenses to help post Lasik complications. There are large RGP lenses available without the need for scleral lenses, if that is what you want."

Does anybody have any experience with the large RGP lenses he is referring to? What is the difference between a large RGP lens and a scleral lens? I thought a scleral lens WAS a large RGP.

Scleral is not defined just by size but by where it rests. It has to completely vault the cornea to be called a scleral lens. They are designed to not touch the cornea and also to hold a deep fluid layer over the entire cornea. This is a question of shape/design, not just size. For example, back in the early days when DrG was making his excellent lenses for me, I had 14.5mm reverse geometry lenses (so called because they were flatter in the center, to match my flattened corneas) but I have heard of people getting lenses in that size that the practitioner was calling a mini-scleral.

There's a ton of good information about this on DrG's website - check it out here: http://www.globalrefractivesolutions.com

I think that another member of this board somewhere in the midwest is currently in the process of trying to get a good fit of a lens which I suspect is similar to what Dr. Lee is proposing. You might want to dig around on the board a little to find them and ask how they 're doing.

Another thought: Ask Dr. Lee if he's got another LASIK patient you might be able to talk to. It'd give you a chance to get basic questions answered to help set expectations about what it might be like.

I've had lenses over the years from DrG and from Boston Foundation for Sight. They are the only ones I have personal experience with enough to trust with the results, and DrG is really the only one whose patients talk about him a lot on the internet so it's hard to judge how successful complex post LASIK fittings are doing these days in the hands of other skilled optometrists. Actually I just remembered one other longtime forum member who has had success with lenses from Dr. Lee. He was an RK case not LASIK. Those are even more tough.

[vancouver-lasik-victim]

thanks for your reply Rebecca. I didn't know anybody had replied...I thought I set my profile to automatically subscribe, but I guess not.

Anyway, I've manually subscribed and am continuing to explore/search based on your suggestions. I don't think I found either of the members you were alluding to, but I've PM'd a couple other board members that may have relevant information based upon searches I conducted tonight. I'll probably post some follow-up after doing some more research.

During my searches tonight, I also came across several heart-breaking posts from members suffering even worse than me. Part of me says, "well I could be worse off!" But mostly it makes me sad/angry. My main objective is to restore some/most of my quality of life, but I'm curious if you know of any efforts through lawsuits (in US or Canada) or even protest groups to stop lasik surgery and prevent others from going through this ordeal?

thanks,
Kevin

[spmcc]

Re: message to Kevin

Hi Kevin,

I PMd you with a little info.

I've never heard of Lee. But I would still recommend that you get a referral through Health Canada to go to the Boston Foundation for Sight (BFS). They seem to be the people who know the most about pain relief (versus vision correction).

I've never been to the BFS, but that's what I suggest if you have the patience to wait for approval.

Good luck.

[gz9gjg]

Hello Kevin,

I have been wearing Wave RGP lenses successfully since 2002, after LASIK in 2000. The Wave lenses website has a doctor locater: http://www.wavecontactlenses.com/

I found the Wave lenses to be much less expensive than sclerals or Dr Gemoules. The lenses are designed by an expert OD with the assistance of topography measurements that are taken with a no-contact device. You do need to work with an OD who fits difficult cases, such as Keratoconus, and who is willing to consult with the Wave company to get the best result. My Wave lenses are comfortable for 12 to 14 hours per day, and give me superb vision. They correct 95% of my HOAs and give me my night vision back.

Good luck . . .

Lynne

[Brooke]

Do wave RPGs help with dry eye pain?

Lynne and Rebecca,
I've had lasik and my vision is fine. However I have pain from MGD and possible cornea neuralgia. Could wave RPG lenses help in this case or would a scleral be the only option for that?

Thanks.

[Jade]

rgp lens

Kevin,
I just got fitted for a RGP lens that covers the entire cornea and the edges sit just into the sclera. (It'll cost just over $200) I'm trying it because I have RCE's on my RK scars on my right eye and I want something to vault the scars, have somewhat of a normal tear layer under the lens, and have near 100% oxygen getting through. I still don't know how I'll do with the comfort, until I try it when it's ready for me in a couple weeks. Until then I'm wearing an acuvue oasys extended wear lens as a bandage lens 24/7 to see if that will help heal my RCE's. I talked to a dr who did custom WAVE RGP lenses but said my total cost would be 5 grand and he was far away from me.

[Rebecca Petris]

I've had lasik and my vision is fine. However I have pain from MGD and possible cornea neuralgia. Could wave RPG lenses help in this case or would a scleral be the only option for that?

If you're trying to address corneal pain you do not want a lens that rests on any part of the cornea. According to the WAVE website, they go up to 15mm, i.e. a mini-scleral.

To the best of my recollection I have never personally heard of anyone getting WAVE lenses for dry eye, however, you may want to contact the company for more information.