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Medical Forum / General / Vision / December 2004Piggy back question
I wear RGP contacts in the evenings because of starbursting, ghosts, etc caused by LASIK surgery. But I don't tolerate contacts well. Wearing them requires using Auify eyedrops every hour. I tried piggybacking Focus N&D and Acuvue Advance. One is not better but the Acuvue has a tint, making it less likely to get lost going between the case and my eye. The original description of piggybacking says to put the soft lenses in first. Doing that did not work so well for me. I still have the edge sensation. Doing the opposite--putting RGP lenses in first--works much better, allowing me eight hours of wear without hourly eyedrops. The problem is the soft lenses change my focus. Even plano N&D lenses. My question is, can hard and soft lenses be matched in presciption? That is, hard lenses a bit undercorrected with soft lenses overcorrected enough to balance it out? TIA, Kevin > The problem is the soft lenses change my focus. Even plano N&D lenses. > My question is, can hard and soft lenses be matched in presciption? > That is, hard lenses a bit undercorrected with soft lenses > overcorrected enough to balance it out? Although I hadn't heard of doing it that way, when you have both lenses on it should be possible to overrefract and arrive at a new, better power for the soft contacts. The problem may be that the doctor you visit might blow his top because it's so unconventional. I'd want to look at your cornea late in the day, checking to see that the GP still moves underneath and you aren't getting a circular "footprint" or staining from poor circulation under the lenses. If not, I'd grudgingly go along with it and ask you to come back more frequently (eg every 6 months) to make sure your cornea stays healthy. I'm surprised it's more comfortable that way, but I've been surprised before. :) -MT Thanks for the replies. The doctor has no experience with piggybacking so just sort of shrugged his shoulders when I asked about it. I made the three-hour drive today to let him inspect my left RGP, which causes a lot of discomfort. I didn't have the chance to bring up piggybacking. He is ordering a new RGP. When it comes in I'll drive down again but this time I'll bring the soft lenses also. Hopefully he can see if wearing my backwards piggyback will lead to problems. I understand about the hard lens being trapped beneath the soft lens. I don't think it's a factor for me. My flattened cornea doesn't hold the RGP too well anyway. I've found it eventually squirts out from under the soft lens and centers itself atop it. It happens in the shower every time. Jeez, am I the only LASIK victim with these problems? > Thanks for the replies. The doctor has no experience with piggybacking > so just sort of shrugged his shoulders when I asked about it. I made [quoted text clipped - 10 lines] > shower every time. > Jeez, am I the only LASIK victim with these problems? Kevin, you need a better solution. You are a stereotypical "tinkerer." The idea of wearing a soft lens over an RGP is not new, as I first heard of this about four years ago from an O.D. who used this on keratoconus patients. RGP lenses for keratoconus patients tend to be very small, which enables the soft lens to provide much better coverage. You may need a specialist, but of course neither of us has any idea where one can be found, do we? I might suggest looking at various BB's for someone like who likes to do that kind of work. DrG out of curiosity, what was your myopia prior to lasik? i am considering lasik myslef with prescription glasses -11 and -8 (and astig -3 -2) > Thanks for the replies. The doctor has no experience with piggybacking > so just sort of shrugged his shoulders when I asked about it. I made [quoted text clipped - 10 lines] > shower every time. > Jeez, am I the only LASIK victim with these problems? >I wear RGP contacts in the evenings because of starbursting, ghosts, > etc caused by LASIK surgery. But I don't tolerate contacts well. [quoted text clipped - 17 lines] > > Kevin Ask your eyecare professional about the possibility to use RGP contactlenses with a softlens coating Kevin.(I'm not familiar with the possibilities in the USA, ask the "Americans" here) The type of piggy back system as you invented yourself is not a good one. Putting the soft lens on top of the RGP causes problems, more exact, your RGP in a short time became covered with a protein layer. Why? The RGP lens does not move which it has to. Normally the movement of the RGP causes the debris underneath this lens to exchange by pumping a tearflow, a many times forgotten issue in hard ones. Also the front side of the RGP is not wiped clean when you wear the RGP beneath the soft one. In earlier postings you already are advised to discus this with your specialist and also you are told the RGP lens on top is the way to wear this piggy back system.  SignatureJan (normally Dutch spoken) >>I wear RGP contacts in the evenings because of starbursting, ghosts, >> etc caused by LASIK surgery. But I don't tolerate contacts well. [quoted text clipped - 34 lines] > specialist and also you are told the RGP lens on top is the way to > wear this piggy back system. I would like to ask Jan about an RGP with a soft lens coating. To my knowledge there is nothing like that available here, although I have inquired about it. I have a copy of a patent. DrG > I would like to ask Jan about an RGP with a soft lens coating. To my > knowledge there is nothing like that available here, although I have > inquired about it. I have a copy of a patent. > > DrG The lens material is called Memoflex. The thin hydrophilic layer of 3 micron is made on the surface by polymerization. Me is told this type of contactlens is not available in the US due to the very time-consuming regulations to get the material registered by the FDA. It comes from outside the US and that even makes it even more difficult and time-consuming. I love my country where some regulations are not so defensive as they are in the US. On the other hand, The Netherlands being a test plot for many things in the contactlensfield makes you very cautious SignatureJan (normally Dutch spoken) |
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