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C3R vs ICL

Hi Doctors,
on a recent eye check up of my brother one Doctor suggested ICL and another doctor suggested C3R. It is been almost 6 years he struggling with changing numbers and his right eye almost blurr now. He can just see a object but cant recognise what it is. So at this stage one doctor is suggesting for ICL where as another doctor suggested that C3R. The doctor who suggested C3R said very clearly that ICL is not the solution for this. So we are dilemma now. So my question is
Question #1 :-Is it possible to have ICL done after a C2R is Done if required?

As of now we are planing to go for C3R and I just anted to check if in case required is it possible for him to get the ICL done?
4 Responses
Avatar universal
I was curious what C3R is, I didn't remember that abbreviation before, though I'd heard of the treatment once I saw what it stood for.   I see descriptions like the one on this page:

http://www.bhargavaeyecentre.com/WebPages/Glaucoma_Servies.aspx

that explain it is used to try to stabilize the eyes of people with keratoconus to prevent further changes.

Implanting an ICL is merely an alternative to wearing contacts or glasses and serves a different purpose. The first step is to stabilize the cornea. If someone gets an ICL without stabilizing their eye first,  and their cornea keeps changing, then they will need to start wearing correction again to keep up with the changes (since you don't want to be having surgery all the time to change the ICL out after the cornea changes). It is true that after getting an ICL the correction needed for any changes afterwards will be less since the ICL corrects most of it, but it seems more useful to first stabilize the cornea.

The American Keratoconus Association explains:

http://www.amkca.org/treatments/insertable-contact-lenses-icl
"Corneal rehabilitation procedures (Intacs®, Corneal Collagen Crosslinking with Riboflavin, and CK) are considered "Part 1". For patients who desire further improvement in vision without constantly using glasses or contact lenses, the Visian ICL is considered "Part 2." Three months after "Part 1", patients can consider the Visian ICL to further improve their vision."

For instance here is an abstract from a conference paper for eye surgeons that reports on:

http://www.escrs.org/amsterdam2013/programme/free-papers-details.asp?id=15808&day=0
"  IMPLANTABLE COLLAMER LENSES (ICL‘S) IN KERATOCONUS: A DEFINITIVE TREATMENT ...
Conclusions:

Implantation of ICL following stabilization of keratoconus with C3R or Keraring is a safe and effective option. Hence ICL is a much awaited definitive and rewarding form of treatment in patients with keratoconus."
177275 tn?1511755244
ICL is NOT for keratoconus. The treatment of choice is the C3R procedure.

JCH MD
Avatar universal
Hi sir,
1 year before i planed for the lasik treatment due to my corneal damage doctor kept me under observation and now he suggested to take ICL, prior to that he asked me to get done with C3R surgery. Now i little worried about the C3R please suggest me how safe is C3Rr before ICL.
177275 tn?1511755244
I believe that most eye physicians would not recommend intraocular contact lens in a patient with K-conus unless: The residual glasses RX was greater than-10.0 and the person unable to wear contact lens and the person understood the significant risks associated with intraocular contact lens and the les being used was: –the Verisyse and the Visian ICL.

JCH MD
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177275 tn?1511755244
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