ASK Dr. ARTSYBASHEV!

Dr. ARTSYBASHEV Sergey is happy to answer your any QUESTIONS regarding KERATOCONUS:


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Reply will appear here on message board. Questions with attachments can be send to arcibasev[at]arcibasev.t-online.hu

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Corneal Scarring after CXL:

Dear Dr. Artsybashev

I suffer from Keratoconus and had crosslinking epi-off done in January 2018 which resulted in deep corneal scarring. My vision is now worse than before, 20/100 and only correctable with hard lenses/sclerals to 20/40.

Most doctors said the only possibility for me to regain full vision would be a cornea transplant and that laser procedures won't work because my cornea lost too much thickness as a result from the scarring (328um in the middle, 398um at the edges).

Is a cornea transplant my only option or are there other possibilities? I've asked already about TG-PRK.

I can send you a condensed documentation of my eye case upon request.

Thank you a lot in advance.

Kind regards,


Dear Sir

Thank you for contacting Artsybashev Keratoconus Center. 

I'd send you my reply and preliminary opinion on condition of your corneae and on further perspectives if I could examine your last results of corneal topography (colour topograms of corneae) and visometry (with and w/o correction), attached to email message. 

Kind regards, Dr. Artsybashev Sergey, email address:  arcibasev[at]arcibasev.t-online.hu 

: After CXL or instead of?

Dear Dr. Artsybashev!  

Does your keratoconus method work also on crosslinked cornea? Will dimensions of cone decrease, despite irregular stiffness of crosslinked cornea? 
What is the difference between your keratoconus surgery method and classical refractive radial keratotomy? 
What determines the cost of your keratoconus surgery? 
Could you give in e-mail preliminary prognosis of results of your keratoconus surgery in someone's case? 
 
Thank you for your reply in advance!

Dear Sir, 
 
My method of keratoconus surgery does work after crosslinking (and also after different types of interventions on cornea such as implantation of corneal ring segments, laser interventions, keratoplasty, corneal transplant). My patients frequently have kind of interventions on cornea in their medical history. Past attempts to halt or slow down the process of progressive keratoconus disease and/or to improve eyesight, do not affect final result of my surgery (extent of regression of keratoconus and improvement in eyesight remains the same) but they make the operation more sophisticated for the surgeon and they may more or less delay rehabilitation of cornea after halting keratoconus process by my surgery. After corneal crosslinking we should wait at least six months before providing my surgery. 
The cost of my surgery depends on the stage of keratoconus (I - late IV), interventions on cornea in the anamnesis, presence and position of corneal opacity (if any). 
If you send us results on your last corneal topography and values of visual acuity with and without correction, I can send you preliminary prognosis of results of my surgery and you can get information on exact cost of surgery on each eye. Fee for ophthalmology examination is one hundred euro in our Keratoconus Center. 
My keratoconus surgery does not refer to type of refractive (optical) surgery because primary result of keratoconus surgery is the regression of cone, and stable improvement or recovery of patient's visual acuity is just the consequence of this controlled regression. Traditional RK method can correct shortsightedness and/or astigmatism in absence of cone (ectatic disease), on healthy cornea.
 
Best regards,  Dr. Artsybashev Sergey

: How to stop keratoconus and improve vision simultaneously?

Good day Doctor Artsybashev!

I have keratoconus disease at the I-II stage. I have checked in several places and all doctors adviced me to crosslinking, while one doctor adviced at first to use hard lenses for a couple of months and then depending on results we can do operation. Could you please advice me in this case? I will upload my test results from several clinics,

Thanks in advance


Dear Sir 

Thank you for contacting our Keratoconus Center.
On the basis of uploaded results of corneal topography there is keratoconus stage II in both your eyes. 
In this condition of cornea I can help you with my one-step keratoconus surgery in order to halt disease process and significantly improve your vision at the same time, with no need of following hard contact correction. Patients who refer to me in order to stop progression of keratoconus and improve their vision e.g. after crosslinking, can be treated by my method not less than six months following crosslinking intervention. 
 
Best regards, Dr. Artsybashev Sergey 
 
Director
Artsybashev Keratoconus Center
Budapest, Hungary 
www.arcibasevklinika.com

: keratoconus & myopia

Dear Sir, I want to ask you will I need laser surgery for myopia after your surgery and will it be possible to do it after? Thank you.


Dear Sir, I'd like to underline that regardless of my surgery, in condition of keratoconus, laser interventions of optical purpose are contraindicated in order to avoid additional thinning of cornea, thinned also by disease. I always take into account the short-sightedness also and often it is possible in one step to achieve its correction (no need of glasses) together with all other purposes of my keratoconus surgery, depending on extent of myopia. If rarely needed I can correct residual myopia after recovery period following my keratoconus surgery. About all optical perspectives I can give you tailor-made and relevant opinion after your personal ophthalmology examination in our center. Best regards, Dr. Artsybashev Sergey 

: asking for opinion on my keratoconus

Dear Sir, I would like to come to your clinic, I am suffering from keratoconus, I just found out this week, I would like to know what are my options for my problems, Thank you


Dear Sir, Thank you for contacting us. I have examined your uploaded corneal topography results and ophthalmology data. The diagnosis based on them is progressive keratoconus of stage III in both eyes. My preliminary opinion is: I can help you with my keratoconus surgery on both your eyes. In result with high probability can be expected stable halting of keratoconus disease and significant improvement in eyesight without correction. Extent of possible maximal improvement in your visus I can evaluate and prognose after your first ophthalmology examination in our center. With best regards, Dr. Artsybashev Sergey 

: secondary keratoconus following LASIK

Hi, I have been suffering from nearsightedness and astigmatism for as long as I can remember and had LASIK treatment in 2012. After 2 months I started noticing blurry vision, needed to strain my eyes to see the writing on the screen, started feeling dizzy or nauseated from forcing my eyes to focus. In December 2014 did my LASIK surgeon notice that I had developed a malformation in my cornea, keratoconus. He decided to treat it with crosslinking. I had the procedure a few days ago, but unfortunately I feel my eyesight getting worse. As I had the procedure only on my right eye, I can still function, somewhat normally, by using only my left eye. My eyesight in my right eye is basically seeing white light, I cannot focus my eye on reading or making out signs on the street, which means I cannot drive. Could anyone advise me please?


Dear Sir, Thank you for contacting us. I could promptly send you my opinion on actual condition of your cornea and on further perspectives if I could take a look at your last (after crosslinking intervention) corneal topography results (scanned topogram colour images of both eyes) and at your actual eyesight (visus) data (with and w/o correction by glasses or contact lenses) attached to your email message. Best regards, Dr. Artsybashev Sergey 

: Keratoconus surgery after crosslinking

Dear Sir, I\'ve been diagnosed with Keratoconus since 2009. I got the C3R done in 2010. Even after that the number kept on increasing. In 2014 when I visited the Doctor He adviced me for Intacs. I read about you on the Internet. Please advice what should I do. I am attaching all my reports. Pl. reply at your earliest, Brgs


Dear Sir, Thank you for contacting us. I have examined your corneal topography results and
anamnestic ophthalmology data carefully. The diagnosis based on them is progressive keratoconus stage IV in the right eye and progressive keratoconus stage III in the left eye. The cone became more centralized in both eyes and therefore visual acuity is decreasing (especially in the right eye). In the right cornea can likely be opacities. I can help you with my keratoconus surgery on both your eyes. In result with high probability can be expected stable halting of keratoconus disease and significant improvement in eyesight without correction. The extent of possible maximal improvement in your
visus I can evaluate and prognose after your first ophthalmology examination in our center. Regarding corneal implants: keratoconus surgery can be provided even after implantation, if progression
of keratoconus and worsening of eyesight are going on, but recovery period is longer and surgery is more sophisticated in such case, and feasibility depends on method of implantation (femtolaser or other). With best regards, Dr. Artsybashev Sergey 

: Keratoconus surgery after crosslinking

Dear Sir,

I am suffering from keratoconus in my left eye. I had seen the surgical treatment for keratoconus in your website and found really exiting. Since all my doctors clearly said that only treatment for keratoconus in C3R to halt the progression but no other treatment are available to reduce the progression. Request you to kindly let me know the advantages and disadvantages of the surgical treatment/diamond ophthalmic surgery for keratoconus and visual actuity achieved by this surgery. Presently I am using RGP contact lenses for my left eye and its working fine. Can I shift to use soft contacts if I undergo the surgical treatment/diamond ophthalmic surgery? Is this surgery FDA approved, and why this technique is not available/familiar with any other doctors across the globe?

Please find the topography report performed on 1 March 2011. C3R was performed to my eye on 30 May 2011. I am having regular follow ups with my doctor every 3 months and topography tests are regularly conducted. The topography results seem to be steady and the progression has halted as communicated by my doctor.

Awaiting your reply

Thanks and Regards,


Dear Sir

Thank you for contacting us!

The surgical keratoconus technique developed, introduced and performed by me is an innovatively modified version of radial keratotomy. Peripheral micro-incisions are used to reduce the steepness of the cornea caused by keratoconus. micro-scars formed during the recovery process keep the cornea from reverting to its former shape and induce emergence of new, ’healthy’ corneal collagen. The keratoconus stops progressing and in most cases a continued reduction in the cone is noticeable. That is why rigid contact lenses usually become unnecessary after my keratoconus surgery.  http://www.arcibasevklinika.com/keratokonus.htm

Currently, there are only a very few surgeons in the world providing modified versions of radial keratotomy as a treatment option for keratoconus patients. The procedure is not widely performed as the results are directly tied to the skill, training, and experience of the surgeon. Radial keratotomy is approved in US.

After looking at your preoperational topography results it would be useful to have an opportunity to compare them to the very last postoperational topography results if you could send us them attached. Can you tell me your minimal corneal thickness and current vision both with and without correction? With this information I will be able to provide you with a more direct and individual response as to the possible benefits of the operation.

Best Regards,

Dr. Artsybashev Sergey

: Keratoconus surgery after crosslinking

Dear Sir,

I'm 25 ys old. I've been diagnosed with keratoconus in 2011. Since then, I have done crosslinking on both eyes. My current situation is : keratoconus stage 2 on left eye and stage 1-2 on right eye. I heard about this type of treatment from a friend, who did it in your clinic. I'm interested in this type of treatment, so I have to ask you a few questions :

- when can I get an appointment and treatment?

- may I have surgery for both eyes in the same day?

- is it possible to solve this issue without translation, just using English?

I have attached also the last topography results I have.

 

Best regards,


Dear Sir

Thank you for contacting us!

Regarding to your questions:

If we treat both eyes, the program looks like this:

1st day: pre-operational examination and surgery of the first eye;

2nd day: control examination of the first eye, surgery of the second eye;

3rd day: control examination of the second eye.

This surgery intervention should not be done on the same day on both eyes, because it is important and obligated to go in accordance with the proven program.

After crosslinking on both eyes, the status of your keratoconus is the following, based on your last year topography data: right eye, stage 1-2 keratoconus; left eye, stage 2-3 keratoconus. In our Center we have to check your current status and stage of keratoconus in both eyes.

It will be possible to communicate in English in our Center. Agreement on possible dates of appointment we can make after you have sent us your suggestions.

 

Best regards,

Dr. Artsybashev Sergey